Clostridioides difficile (formerly Clostridium difficile) is a Gram-positive, spore-forming, toxin-producing anaerobe, best known for causing antibiotic-associated diarrhea and pseudomembranous colitis [1]. The first reported extracolonic C. difficile infection came in 1962, C. difficile is occasionally isolated from extraintestinal sites and is usually found as part of polymicrobial biota [2,3]. Robinsoniella peoriensis is a Gram-positive, strictly anaerobic, spore-forming bacillus, that has been reported to cause bacteremia, bone and joint infections and endocarditis, however, it has not previously been described as a respiratory pathogen in humans before [4]. Herein, we describe an unusual case of a man in his late-60s who presented with pleuritic chest pain and dyspnea and was found to have a right sided pleural effusion caused by Clostridioides difficile, Clostridium tertium, and Robinsoniella peoriensis with stool samples negative for C. difficile glutamate dehydrogenase assay.