I went to ER on the 9 of Jan I had flu like symptoms and what I thought was a yeast infection. It burned to pee and itched. Doc there checked me and said he believed I had HSV only by visual exam. He did a swab on me and said I would have results in 2 days, he told me he was sure I had that. I waited for a week and never received results, found out the week after labs were never done. I went with my OBGYN 3 days after ER visit and she checked, she said I had very little ulcerations but they did not have any fluids but had irritation she tested for yeast and other infections, I was positive for yeast infection and bacterial vaginosis. After applying the cream I instantly felt better and didn’t hurt to pee. She did a culture swab last week, came back negative but it can be not accurate I want to know steps I can take next to test for HSV that can give accurate results? because the lab was never done at the ER and I no longer have ulcerations and didn’t develop scabs after either. 

What a shame that the labs were never done!  They should have been.  There must have been something quite clear in the exam for the doctor to say he was sure you had HSV.  And a visit to your OB several days later would not be the same presentation, right?  ---

Hello! Thank you for your response. Yes when I went to my OB 3 days later and she examined me she saw erythematous ulcerations present at introitus of vagina, but no vesicles present. I was prescribed acyclovir and told to take it for a week but when I visited my OB 3 days later the medicine was not helping me with the irritation of vagina it still would hurt to pee. When I self swabbed and it turned out I had yeast infection she had prescribed me the cream and only that helped with irritation and was able to use the bathroom without it burning. I did have a new partner, no condom was used, I did not receive oral sex but I did give oral sex. I have never had a cold sore lip and till now I don’t have signs of any cold sores. Is it recommended from you to do the IgG testing now? Since this happened barely on the 9th or Jan Or should I wait the 12 weeks usually recommended after possible infection? Because at this time I am very confused if I have the virus or was wrongly visually diagnosed since labs were never done. 

You could wait and test at 12 weeks out but it might be useful to test now for a baseline result, and doing it again at 12 weeks, looking for a change between the two results to indicate a new infection.---

Okay that’s very helpful thank you. Do you think that this could have possibly also been a bad case of a vaginal bacteria? Because I did come out positive for bacterial vaginosis and the yeast infection and I have had yeast infections a couple of times in the past and for my understanding each time can potentially get worse. Also when I retest in 12 weeks again would that be considered an accurate result for me? Thank you so much for taking your time to respond to my questions by the way! 

No, BV, bacterial vaginosis is not an inflammatory condition.  The yeast infection could have been bad enough to cause ulcerations but that's not very common.  The IgG test at 12 weeks out misses 30% of HSV 1 and 8% of HSV 2, compared to the western blot so pretty good for HSV 2, not great at all for HSV 1.  That's why I think the baseline comparison would be very helpful but if you are going to do the baseline, do it now---