Physician called augmenix to request information on our historical infection rate associated with spaceoar.He had a patient with an active infection that he treated post high dose radiation (hdr) and spaceoar placement.His thoughts were that the infection was not directly related to spaceoar gel.One week after treatment-patient presented with transperineal pain.Medrol dose pack was prescribed and pain went away.Two weeks after treatment- patient re-presented with transperineal pain.Medrol dose pack prescribed a second time and pain went away.On (b)(6) 2016 - took mri and confirmed spaceoar hydrogel was between rectum and prostate.Rectal wall thickening is present on mri and hyper intense signal is hydrogel, not abscess.Patient was having persistent pain in the perineum which is worsening.Pain persistent and mildly elevated white blood count to 10.5.This elevated count thought to be due to the prescribed steroids.On (b)(6) 2016 - patient presents with white blood count elevated up to 17.Patient is given a contrast enhanced ct scan to check for rectal wall perforation.No perforation is observed.Urethrogram performed to confirm no fissures within urethra, none observed.Ct scan reveals some air collections between the prostate and the rectum and the area of the penile bulb region.Physician very concerned about infection.Oral antibiotics prescribed at this time are ciporo, flagil and bacterin.On (b)(6) 2016 - patients perineum pain is worsening.An additional ct scan is taken and the air collection diagnosed (b)(6) remains in place, no additional air seems present.White count is down from 17 to 14 today.Patient admitted and trans-perineal incision allowed for 20cc pus to be extracted.On (b)(6) 2016 - physician indicated that patient is doing well and asking to be discharged.They were keeping him a bit longer on iv fluids, meds, and monitor.
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