Evaluation of ten children with Pseudomonas bone and joint infections resulting from puncture wounds of the foot identified a definite pattern to sequelae. The longer the symptoms were present before adequate treatment was instituted the greater was the risk of bone and joint destruction along with the development of chronic osteomyelitis. The syndrome usually does not produce systemic signs, but the patterns is characteristic and should be considered after any puncture wound of the foot in which the symptoms worsen instead of improving with time.