Brief Answer:
Combined blood test & culture is more accurate.

Detailed Answer:
Hello,

Thanks for writing to us.

Genital herpes is often difficult to diagnose & may be confused with other diseases as it is not always seen with classical symptoms. Most women remain asymptomatic & in latent phase. However, combined clinical examination and laboratory investigation is more conclusive to confirm the diagnosis.

Now, come to your case. You have mostly latent phase of genital herpes due to presence of single lesion with itching. Also culture is positive for herpes.

1) False positive culture test is much rare but it can happen, depending on test method and laboratory.

2) Combination of culture and blood test is more accurate to diagnose latent phase or asymptomatic genital herpes. You can undergo following blood test:

a) Direct fluorescent antibody (DFA) test or Polymerase chain reaction (PCR) to detect virus.
b) New test Immunodot Glycoprotein-G Specific (IgG) HSV test is more than 98% specific in differentiating HSV 1 & 2.

3) Itching is common with genital herpes but it can occur with sweating, tight underwear, chemical subs/ bath products/ soap etc. You have to eliminate these predisposing factors at the earliest.

Here, you would continue anti-viral medication (Valtrex) as prescribed by your OBGYN. Additionally, you will take anti-histamine medication like levocetirizine etc & apply anti-bacterial cream to reduce itchiness. Take local hot compression and maintain genital hygiene properly.

Hope, I have answered your queries. Let me know, if you need any clarification.

Wish your good health. Good luck.

Regards,
Dr Soumen

---