Mycoplasma pneumoniae infection most commonly manifests as a mild respiratory illness and headache. Pneumonia occurs in approximately 10% of patients with respiratory symptoms. M. pneumoniae infection can also cause neurological and other extrapulmonary complications. In this case report we describe a 33-year-old Caucasian man presenting with headache and raised intracranial pressure, found to be a para-infectious complication of M. pneumoniae infection. Nasopharyngeal PCR was highly useful in facilitating early diagnosis, as IgM antibodies were negative during the early stages of illness. Azithromycin is the preferred agent for M. pneumoniae treatment. The addition of M. pneumoniae PCR to hospitals' rapid respiratory viral PCR panels could promote early directed therapy and antimicrobial stewardship.