A 25-year-old woman presented after 10 days of severe diffuse abdominal pain. Seven months prior, she had been seen at an outside hospital with similar complaints. Evaluation then included negative test results for pregnancy, bacterial vaginosis, Chlamydia infection, and gonorrhea. Three months later, she again presented with abdominal pain and cervical motion tenderness on pelvic examination. A wet mount revealed cells consistent with bacterial vaginosis. She was given a diagnosis of pelvic inflammatory disease (PID) and treated with metronidazole and doxycycline.