A 42-year-old male presents with fever for 8 days, severe headache, generalized weakness, and myalgia. For the last 2 days he has developed abdominal discomfort, vomiting, and reduced urine output. He reports intermittent chills but no documented temperature chart. He took paracetamol and an unknown antibiotic from a local pharmacy with temporary improvement. On examination: BP: 92/58 mmHg Pulse: 112/min RR: 24/min SpO₂: 96% on room air Temperature: 102.4°F Mild dehydration Diffuse abdominal tenderness, more prominent in the right upper quadrant No obvious rash Mild confusion but follows commands No neck rigidity Initial investigations: Hb: 10.8 g/dL TLC: 14,800/µL Platelets: 68,000/µL Creatinine: 2.4 mg/dL Urea: 78 mg/dL AST: 186 U/L ALT: 142 U/L Total bilirubin: 3.1 mg/dL Sodium: 128 mmol/L Potassium: 4.7 mmol/L CRP: markedly elevated Urine: protein 2+, RBC 8–10/HPF Peripheral smear: thrombocytopenia, no malaria parasite seen The patient lives in a rural area and works outdoors. His wife mentions that he had multiple insect/tick exposures approximately 2 weeks ago. He also had an episode of dark-colored urine yesterday. AI task Do NOT immediately diagnose or prescribe. Ask me the most important targeted questions first, prioritizing questions that would help differentiate among: Severe sepsis/septic shock Scrub typhus/rickettsial infection Severe dengue Malaria Leptospirosis Enteric fever Acute viral hepatitis Acute kidney injury with systemic infection Other tropical infections Ask questions one at a time, like a real clinical AI consultation. After sufficient information is obtained, give: Most likely diagnosis Differential diagnosis with reasoning Investigations required urgently Severity/risk assessment Immediate management priorities Appropriate antimicrobial/antiparasitic therapy if indicated Red flags and ICU indications What information is still missing before making a definitive diagnosis.