eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-09-29 8 12 535 537 10.12691/ajmcr-8-12-28 AJMCR202081228 article Monica Bapna 1 Maham Mehmood mahum.arshad89@gmail.com 1 Asim Haider 1 Icahn School of Medicine at Mount Sinai at BronxCare Health System Bronx, NY, USA Mycoplasma pneumoniae is known to cause atypical pneumonia, but not aspiration pneumonia, macrolides are still considered the first-line therapy. Typical antimicrobials used to treat aspiration pneumonia does not cover atypical pneumonia, here we report a case of a young, previously healthy female with no significant medical history, who was in her usual state of health before she was brought to the hospital with altered mental sensorium, preceded by benzodiazepine intake that she bought from the street. She had imaging and labs consistent with acute hypoxic respiratory failure due to aspiration pneumonia, was intubated and started on mechanical ventilation. She was found to be co-infected with mycoplasma pneumonia and streptococcus pneumonia, successfully managed with intravenous antibiotics, and eventually liberated from the ventilator and was safely discharged home. http://pubs.sciepub.com/ajmcr/8/12/28/ajmcr-8-12-28.pdf aspiration pneumonia mycoplasma pneumoniae streptococcus