Acute Prostatitis and Septic Shock Following Rectal Spacer Placement: A Case Report of a Pre-brachytherapy Complication.

Rectal spacers are commonly used in the treatment of prostate cancer to create a protective barrier to reduce radiation-induced toxicity to the rectum. Despite their safety profile, severe complications such as infections are rare but clinically significant. We present the case of a 69-year-old male with Gleason Grade 3+4 (Score 7) who developed acute prostatitis and septic shock one day after rectal spacer placement. He presented with fever, chills, nausea, and emesis, alongside profound hypotension necessitating vasopressor support. Blood and urine cultures identified Morganella morganii, prompting targeted antibiotic therapy with piperacillin-tazobactam. Imaging revealed abdominal edema and mild ascites without abscess or hematoma. The patient recovered with intensive care and was discharged on a prolonged course of antibiotics. This case highlights the rare but severe infectious complications of rectal spacer placement and underscores the importance of early recognition and intervention. Future studies should explore preventive strategies, including prophylactic antibiotics, to mitigate such risks.