A characteristic vasculitis is an uncommon but well-recognized complication of severePseudomonas aeruginosainfection in the neonate. Although it is one of the most common gram-negative organisms responsible for overall nosocomial infection, it is a rare cause of intrauterine or intrapartum infection of the newborn. We describe a fatalPseudomonas aeruginosainfection occurring in a very premature infant with widespread skin necrosis. Although this organism is relatively uncommon in the neonate, premature infants are at increased risk of infection, with a significant associated mortality. Early recognition and treatment are therefore very important.