Key points: Diagnosis of AIFRS should be alert in the immunocompromised patient presenting with new-onset, rapidly progressive sinusitis with facial-cranio-orbital spread. Extended debridement should be considered on a case-by-case basis. Antifungal agent contributed greatly to the outcome of AIFRS. Prognosis mostly up to the balance of underlying disease and fungal invasion, more emphasizes should be focused on comprehensive treatment. AIFRS with facial-cranio-orbital involved often had a disastrous end.