Herpes is a virus which can infect the esophagus. It may do so in a patient whose immune system is compromised with chemotherapy or HIV. It is also seen in perfectly healthy people for reasons we don't know. Image 1 shows punched out ulcers scattered throughout the esophagus. Note there is little inflammation or reddening around them. Image 2 shows what they look like several days later. Now they have whitish exudate or necrotic debris in the ulcer. In Image 3 you see a single very acute herpes ulcer, again without surrounding inflammation. The main symptom with herpes esophagitis and ulcers is pain when almost any food or liquid touches these ulcers.