A 28-year-old male from Bihar presents with a 3-month history of fever, progressive abdominal distension, and weight loss. On examination, he is cachectic with hepatosplenomegaly (liver 5 cm, spleen 8 cm below costal margin). Hemoglobin is 8.2 g/dL, WBC 2,800/μL, platelets 95,000/μL. Bone marrow examination shows oval, intracellular amastigotes within macrophages. What is the most appropriate next step in management?

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