Introduction: Mycoplasma pneumoniae is a common causative agent of atypical pneumonia, the main characteristic of which is the discrepancy between clinical data and radiological findings. Diagnostic confirmation is achieved by detecting the organism through culture or PCR, or by detecting IgG and IgM antibodies. Diffuse alveolar hemorrhage (DAH) is a clinical syndrome that generally manifests with hemoptysis, anemia, and the presence of infiltrates on chest x-ray. From an anatomical point of view, DAH is defined as the presence of blood in the distal alveolar spaces without any endobronchial abnormality being identified. Clinical case: Patient 5 years old with a diagnosis of hemolytic anemia since 3 years on treatment with Mycophenolate and Prednisone, with a diagnosis of pneumonia associated with health care, empirical management is started based on voriconazole, trimethoprim / sulfamethoxazole, macrolide, carbapenem and glycopeptide because the patient is immunocompromised and opportunistic microorganisms are suspected. HRCT with ground glass pattern and viral panel by PCR (FilmArray) positive for Rhinovirus and Mycoplasmapneumoniae are reported, treatment is adjusted with gamma globulin (two doses) and prednisone 20 mg / day; completes 12 days with macrolide; associated with the multidisciplinary management already mentioned, the patient improves. Conclusion: Infections caused by Mycoplasma pneumoniae present variable clinical pictures, at the pulmonary level, there are case reports with diffuse alveolar hemorrhage, whose management should be multidisciplinary, the use of gamma globulin and steroid associated with antibiotic treatment with macrolides has been described, with a satisfactory evolution of the patients.
