We report on a case of acute primary HIV-esophagitis in a 29-year-old man, who presented with fever, diarrhea, odynophagia and a skin rash. Endoscopy of the esophagus revealed multiple small shallow ulcerations. HIV-1 p24 antigen could only be shown in the blood on the day of admission to hospital, 7 days after the acute onset on the disease. Seroconversion for HIV-1 antibodies took place 2 days after the onset.