3 Days Of High in Surgery — Case | Neurosurgery | SMLE Q#11687

SMLE Question #11687

Surgery Neurosurgery

Objective: OBJ-310

Last updated: February 2026
A 26-year-old primigravida presents to the emergency department 10 days after an uncomplicated vaginal delivery with 3 days of high fever and severe midline low back pain. Over the last 24 hours, she developed progressive bilateral leg weakness and new urinary incontinence. Examination shows marked lumbar spine tenderness, bilateral lower-limb power 3/5, and decreased perianal sensation. MRI of the lumbosacral spine shows a posterior epidural fluid collection at L4–L5 with mass effect on the thecal sac. What is the most appropriate next step in management?

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