A 28-year-old man from Tamil Nadu is admitted on day 8 of fever with jaundice, acute kidney injury (creatinine 3.2 mg/dL), and pulmonary crackles. Chest X-ray shows bilateral alveolar infiltrates. Serology (MAT) is positive for Leptospira interrogans serovar Copacabana (titre 1:1600). Blood culture is negative. What is the most appropriate immediate next step in management?

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