Case report on a 57-year-old man who died in progressive respiratory distress with bilateral infiltrates. Sarcoidosis was suspected because of the presence of non-caseating epitheloid granulomas in transbronchial lung biopsies and the elevation of circulating antibodies directed against Kveim antigen. Temperature rose progressively one month after starting steroid treatment. Broad spectrum antibiotics were given without success. Autopsy showed invasive isolated pulmonary cryptococcosis.