Information from:
http://www.genitalherpes.com/info/treating/expect/diagnosis.jsp

Herpes Symptoms and Diagnosis

If you suspect that you may have or have had herpes symptoms, it's important to see your doctor as soon as possible for a diagnosis. Your healthcare provider may begin with a discussion of your herpes symptoms and sexual history. Afterwards a physical examination and any necessary tests your healthcare provider may think are appropriate will be performed.

Because of the wide range of genital herpes symptoms, and the fact that you may not be experiencing symptoms when you see your doctor, he or she may perform tests to make or confirm the diagnosis. Try not to feel uncomfortable or embarrassed talking about your sexual history with your doctor—remember, he or she is not judging you. The information your doctor may ask you for is important and will help him or her to make the best diagnosis possible.

Physical Examination

If you have what is considered to be a "classic" presentation of herpes—meaning you have painful, clustered blisters or ulcers on top of red, swollen skin and you know you've been exposed to the herpes simplex virus—the diagnosis may be made based on herpes symptoms alone. However, the classic presentation of genital herpes occurs in only about 20% of infected people.

Genital herpes may be difficult to identify clinically (by physical examination). Genital herpes symptoms may be extremely mild and easily missed, especially if they occur on the cervix. If you are a women, it's important to know that your routine gynecological examination does not detect GH. Also, you may not be experiencing symptoms at the time of your visit. Some people with genital herpes don't have any symptoms or sores. If you are concerned that you may have genital herpes even though you do not have "classic" herpes symptoms, be sure to talk with your doctor about testing options and describe in detail the types of symptoms you do experience, and their frequency.

You can also check out the Genital Herpes Picture Library to learn more about some of the signs and genital herpes symptoms.

Viral Culture

A viral culture is used to confirm the presence of the herpes virus in a sore. When genital lesions or sores are present, your healthcare provider will use a cotton swab to rub the base of a sore. This swab is sent to the laboratory to test for the presence of the herpes simplex virus.

If the test is positive, you have genital herpes. But if the test is negative, this does not necessarily mean that you don't have herpes. The herpes virus is only present in the sore for a short time. The virus is often gone if your sores are several days old. If this is the case, be sure to discuss other testing options with your doctor.

Serology (Blood Tests)

It's important to ask your doctor about type-specific serology (blood) tests. These tests are very accurate and can determine whether you have a history of genital herpes infections.

If you have had intimate contact with someone who has genital herpes, let your doctor know. If you suspect that you have been exposed to genital herpes, a blood test can be performed to determine if you are infected with the virus. A blood test can also be performed in people who have mild genital herpes symptoms that occur infrequently or not experiencing any symptoms. The blood test for herpes measures your body's immune response (antibodies) against the virus.

Potential Misdiagnoses of Genital Herpes

Diagnosis of genital herpes may be difficult, since many people do not have the "classic" herpes symptoms (painful, clustered blisters or ulcers on top of red, swollen skin). In patients who experience herpes symptoms, the symptoms may appear and then go away after several days, generally recurring in the same location.

Herpes symptoms vary and may include:

*A rash, bumps, blisters, cuts, or sores in or around the genital area (vagina, vulva, anus, penis, or scrotum)
*Itching, burning, or tingling in or around the genital area
*Aches or pains in or around the genital area
*Discharge from the penis or vagina
*Burning and/or pain when urinating
*Flu-like symptoms such as headache, fever, and swollen glands (lymph nodes) in the groin.

These herpes symptoms may be diagnosed as a yeast infection, urinary tract infection, cervicitis (inflammation of the cervix), bladder dysfunction, genital trauma, hemorrhoids, dermatitis, flea bites, or ingrown hairs (pubic folliculitis).

According to the American Herpes Foundation, even the experts in genital herpes misdiagnose genital herpes in about 15% of cases. This is why it is very important to be open and honest with your doctor when discussing your symptoms and sexual history, which will help him or her make the correct diagnosis.

If you are concerned that you may have genital herpes even though you do not have "classic" herpes symptoms, be sure to talk with your doctor about testing options and describe in detail the types of symptoms you do experience, and the frequency of them. You may also want to consider seeking a second opinion if your diagnosis is uncertain.