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An effort to elucidate a subject which is laden with difficulties is noteworthy, so that it was interesting to read the report by Simms et al1 on the associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease (PID). The difficulties are at least threefold. Firstly, a diagnosis of PID based on symptoms and clinical signs, as in the study reported, is acknowledged, both generally and by the authors, to be imprecise. …