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Cryptogenic organizing pneumonia (COP), previously known as bronchiolitis obliterans organizing pneumonia (BOOP), is a serious lung disease that can cause significant and long-term damage to the distal respiratory tract. Here we describe an unusual case in which an adult patient with recent mycoplasma pneumonia developed worsening lower airway disease despite initiation of multiple antibiotic therapies, illustrating the immunological effects related to Mycoplasma infections. It is critical that clinicians learn how to recognize early signs of COP in order to tailor appropriate therapy, reduce morbidity, and improve quality of life.

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