Acute invasive fungal rhinosinusitis is a rare sinonasal infection. It usually occurs in immunocompromised patients. The presentation of acute invasive fungal rhinosinusitis with disseminated fusariosis mimicking varicella zoster cutaneous lesion is extremely rare in otorhinolaryngology practice. The morbidity and mortality rates in immunocompromised patient are high and determined by proper management of the disease. Therefore, appropriate investigation and management are very important. We describe a case of acute invasive fungal rhinosinusitis with disseminated fusariosis in a child presenting with cutaneous lesions mimicking varicella zoster associated with nasal pain and eschar. This report also emphasised the important role of an otorhinolaryngologist in the early diagnosis and management of acute invasive fungal rhinosinusitis.