This is a 8 month old boy with complaints of failure to thrive,recurrent highgrade fever,gross developmental delay.o/e child has pallor, tachypnea with intercostal retractions,tachycardia,bronchial breathing in infrascapular area bilaterally,hepatospleenomegaly,perianal excoriaton.investigations done-hb 9.2gm/dl,wbc-22500,serum electrolytes-s.na-118,s.k-4.55,s.cl-100.chest x ray showed left lower lobe consolidation,homogenous opiate infiltrates present bilaterally significantly on right side,ABGshowed normal values,at present the child is being treated with oxyzen inhhalation at 5 lit/min,inj.amoxycillin-clauvulunate,injgatifloxacillin,injmetranidazole,inj flucanozole,salbutomol nebulization along with antipyretics.present problems are inspite of one month of therapy baby is not shoeing any signs of improvement and is not maintaining oxygen saturation,kindly advise me how to manage this case further?our working diagnosis is acute bronchopneumonia/tb/immunodefeciency disorders.