Invasive　aspergillosis　(IA)　significantly　increases　mortality　in　critically　ill　patients　in　the　ICU　and　its　occurrence　is　closely　related　to　immunocompromise.　Dissemination　of　IA　is　easily　misdiagnosed　and　mistreated　due　to　its　ability　to　invade　multiple　systems　throughout　the　body　and　lack　of　typical　clinical　manifestations.　In　this　case,　a　25-year-old　previously　healthy　woman　was　hospitalized　with　fulminant　myocarditis　and　treated　with　veno-arterial　extracorporeal　membrane　pulmonary　oxygenation　(VA-ECMO)　support　and　intravenous　acyclovir,　high-dose　methylprednisolone,　and　immunoglobulin.　6　days　later,　she　was　successfully　weaned　from　VA-ECMO　and　underwent　cardiac　rehabilitation.　On　day　10,　she　developed　a　fever　(Tmax　38.3　degrees　C)　and　an　irritating　cough　and　began　to　experience　reduced　vision　over　the　right　eye　with　eye　pain,　redness,　photophobia,　and　tearing　2　days　later.　Administration　of　levofloxacin　eye　drops　and　tobramycin/dexamethasone　eye　ointment　was　ineffective.　The　patient　was　positive　for　serum　Aspergillus　galactomannan　antigen.　Positron　emission　tomography/computed　tomography　(PET/CT)　scan　showed　multiple　hypermetabolic　cavitary　nodules　in　both　lungs　(SUVmax3.6)　and　thickening　of　the　ocular　ring　wall　with　hypermetabolism　in　the　right　eye　(SUVmax3.2).　Ophthalmologic　examination　revealed　that　her　best-corrected　visual　acuity　in　the　right　eye　was　reduced　to　light　perception　with　an　intraocular　pressure　of　21　mmHg,　and　B-scan　ultrasonography　showed　vitreous　opacity　and　retinal　edema　with　mild　detachment　in　the　right　eye.　Metagenomic　next-generation　sequencing　(mNGS)　identified　a　large　number　of　Aspergillus　fumigatus　sequences　in　bronchoalveolar　lavage　fluid,　blood,　and　aqueous　humor　from　the　right　eye,　supporting　the　diagnosis　of　pulmonary　and　ocular　involvement　due　to　disseminated　IA.　Vitrectomy,　anterior　chamber　irrigation,　combined　with　intravenous　and　intravitreal　injections　of　voriconazole　and　liposomal　amphotericin　B　eventually　cured　the　patient.　This　case　highlights　the　importance　of　early　identification　and　intervention　regarding　disseminated　IA　in　immunocompromised　critically　ill　patients,　especially　in　the　presence　of　multiple　organ　involvement.