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Problem: Recurrent and persistent unilateral maxillary sinusitis, due to uncommon pathogens, may be caused by foreign objects.
Case report: A 49-year old woman presented with unilateral maxillary sinusitis caused by a Pseudomonas aeruginosa infection. After futile antibiotic treatments, endoscopic drainage of the purulent mucus in the left maxillary sinus revealed the presence of one adult Cyphostethus tristriatus insect, a shield bug species commonly found throughout Europe. After removal of the entomosis, the patient’s complaints disappeared. A fortuitous encounter with a single adult shield bug was presupposed in this case. No evidence of procreation within the sinus was found.
Conclusions: Unilateral sinusitis may be caused by foreign bodies, even when the patient recalls no specific event. To the best of our knowledge, there are no previously published cases of entomosis in the maxillary sinusitis.