Se presenta el caso de una mujer joven, trabajadora de salud, residente en una región altoandina del Perú, con exposición reciente a animales de granja y artrópodos, que presenta síndrome febril agudo indiferenciado, trombocitopenia severa y extravasación pulmonar y abdominal. Posteriormente desarrolla meningitis e hipoacusia neurosensorial bilateral de instalación temprana y muestra serología reactiva a infección aguda por Rickettsias sp. Se discuten las consideraciones epidemiológicas y clínicas en el diagnóstico diferencial para un manejo oportuno.

Pulmonary cryptococcosis (PC) primarily affects immunosuppressed individuals, though not exclusively. The clinical presentation is variable, and reaching a diagnosis is challenging, tuberculosis and cancer being the main differential diagnoses. Due to the neurotropism of this microorganism, cerebrospinal fluid (CSF) analysis is mandatory. Treatment depends on the severity and extent of the disease, as well as the patient's immune status. We present the case of a 74-year-old patient with rheumatoid arthritis, who was being treated with prednisone, leflunomide, and methotrexate. Following a mild COVID-19 diagnosis six months prior to admission, she developed chest pain, productive cough, and progressive dyspnea. A chest CT scan revealed multiple bilateral pulmonary consolidation foci. Histological examination of tissue obtained via transthoracic percutaneous biopsy was consistent with cryp...