A 75-year-old male with severe COVID-19 and acute respiratory distress syndrome developed Cryptococcus neoformans fungemia despite initial negative HIV tests and no apparent risk factors. Despite treatment with remdesivir, convalescent plasma, and dexamethasone, he deteriorated, with persistent fevers and increasing oxygen requirements. Bacterial cultures revealed methicillin-resistant Staphylococcus aureus, complicating his course further. His deteriorating condition, lung tissue damage, and suppressed immune response likely facilitated Cryptococcus invasion. This case underscores the need for early consideration of fungal coinfections, even in patients without traditional risk factors, to enable timely intervention in severe COVID-19 pneumonia
