[The practice guideline 'pelvic inflammatory disease' (first revision) from the Dutch College of General Practitioners; a response from the perspective of gynaecology].

In 2005, the Dutch College of General Practitioners revised their guideline on pelvic inflammatory disease (PID). It is difficult to diagnose PID because of the variability in the presentation of the disease. The revised guideline is a solid guide in the diagnostic process. History taking and physical examination are the most important diagnostic techniques, but require experience. Any diagnostic uncertainty justifies the consultation ofa specialist. The value ofsupplementary diagnostics in a specialist setting is limited. In case of suspected PID, cervical material should always be cultured for Chlamydia trackomatis and Neisseria gonorrhoeae, even if treatment has already been started. Laparoscopy is considered to be the gold standard in the diagnosis of PID. but is only performed if other methods do not suffice. Fast and adequate treatment considerably decreases the risk of serious complications, such as fertility disorders. Therefore, adequate antibiotic therapy covering at least the above-mentioned pathogens should be started if other causes of abdominal pain, such as ectopic pregnancy, appendicitis and torsion of the adnexal mass, have been excluded.