A 42-year-old man was admitted to our hospital suffering from high fever, cough, and progressive dyspnea for 7 days. Three days earlier he was admitted to another hospital, but his condition worsened by treatment with antibiotics. Although he was diagnosed with alcoholic liver cirrhosis several years ago, he did not stop drinking. In spite of another intravenous antibiotic treatment for a couple of days after admission, his ascites fluid had accumulated. The puncture analysis of the fluid revealed an increase in neutrophils, followed by the clinical diagnosis of spontaneous bacterial peritonitis. However, the pulmonary infiltrates worsened and multiple cavity formation was apparent in both upper lungs. Serum β-D-glucan was elevated at 285 pg/ml, and we started treatment with micafungin. After the aspergillus species was cultured from the bronchoalveolar lavage fluid, we diagnosed an invasive pulmonary aspergillosis (IPA). Because renal function was deteriorating, a combination of micafungin and liposomal amphotericin B was started together with ongoing dialysis. However, multiorgan failure soon developed, and he died 14 days after admission. An autopsy was performed that revealed multiple hemorrhagic abscesses with massive fungus formation in both lungs. Aspergillus fumigatus was detected in the bronchoalveolar lavage fluid culture. We conclude that IPA should be considered in patients of alcoholic liver cirrhosis with multiple pulmonary infiltrates.