40 yr old female fever with hepatosplenomegaly sepsis with pre renal AKI with anemia

40 yr old female came with complaints of fever since 20 days and SOB since 3 days GRADE 2 TO 4, vomitings since 1 day, decreased urine output since 1 day
Patient was apparently alright 20 days back then she had insidious onset of intermittent fever,low grade, with evening raise of temperatureassociated with chills and rigors, relieved on taking medication.
From 3 days patient is having sob while washing clothes, cleaning utensils, which was gradually progressive not associated with any orthopnea or pnd or any pedal edema
From 1 day patient had sob grade 4 even on rest had 2 episodes of vomitings non projectile non bilious contains food particles non foul smelling.from 1 day patient is having decreased urine output with sob patient was taken to local hospital, conservative treatment done,and refer to our hospital

Past history: n/k/c/o DM/TB/ASTHMA/epilepsy
K/C/O HTN since 3 years not on any medication
Personal history:consumes alcohol daily since 5 years
General examination:
No picckle
TEMP:98.4F
PR 110
 RR 24
 BP 110/60
 GRBS 86
Systemic: 
CVS s1s2+
RS. Nvbs heard
P/A. Soft non tender, hepatosplenomegaly
CNS. NAD

Clinical images :

Provisional diagnosis :
Fever with hepatosplenomegaly
Sepsis with pre renal AKI with anemia

Treatment:
INJ PAN 40 mg IV OD
INJ ZOFER 4 mg IV BD
IVF NS continuous infusion (urine output+30mL/hr)
INJ PIPTAZ 4.5gm IV STAT
GRBS 6th hourly
STRICT IO CHARTING
MONITOR BP PR SPO2 4th hourly

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