### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
persistent fever I have been having a fever for about 3 weeks now off and on but mostly on it happens in the early evening and gets worse at night I am a diabetic and take metformin I get occasional lower back pain on my right side and this week I started getting a few pains here and there in my lower abdomin on my left side I am wondering what it could be

### output:

Hi ! Good morning. I am Chat Doctor answering your query. There has to be a source of infection to get persistent fever, and in your case, with the history you have narrated of evening rise of temperature specially with a known history of diabetes, the most likely source looks to be a urinary tract infection which could also give rise to both your lower back and abdominal pain. If I were your doctor, I would advise you to monitor your blood sugar level very closely, go for a urine routine/microscopic/culture and sensitivity test so that appropriate antibiotic could be instituted if need be, and possibly an ultrasound abdomen. I would also advise you for a fever profile like a CBC, ESR, Ty phi dot, and blood for MP, with a peripheral smear as well. The management in your case would depend on the results of a physical examination and reports of the related investigations. Till that you can go for an over the counter antipyretic like paracetamol, and an anti-spasmodic for the abdominal pain along with a diabetic diet. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. Wishing you an early recovery. Chat Doctor.