A 7-year-old immunocompetent girl developed Cryptococcus neoformans infection with a mediastinal mass and recurrent fever after 5 months of daily contact with parrot feces. Conventional tests such as fungal culture and serology were negative, the diagnosis was confirmed by targeted next-generation metagenomic sequencing (tNGS) from bronchoalveolar lavage fluid. Treatment included a triphasic antifungal regimen: induction with amphotericin B and flucytosine, consolidation with fluconazole, and maintenance with low-dose fluconazole. After one year of treatment, the mediastinal mass almost disappeared without recurrence. Cryptococcus neoformans typically causes lung infections or central nervous system involvement, a mediastinal mass is a rare manifestation, especially in children. A review of the literature confirms that exposure to parrots is an underrecognized risk factor for childhood cryptococcosis, and tNGS improves the diagnosis of atypical extrapulmonary manifestations. The case highlights the need to investigate pet bird exposure in children with unexplained mediastinal masses and fever.