One hundred Bangladeshi children admitted to hospital for treatment of severe protein-calorie malnutrition were systematically evaluated for the presence of infections. Ninety percent of children had some evidence of systemic infection at the time of admission and 75% had pneumonia, bacteruria, diarrhea in association with a known enteric pathogen, bacteremia, meningitis, or more than one of these major infections. Forty-nine percent of patients had pneumonia, including 14% of admissions with clinical evidence of pulmonary tuberculosis. Forty-three percent of admissions had diarrhea and 40% had evidence of enteric infections, most commonly shigellae or rotavirus. Bacteruria occurred in 30% of admissions, but bacteremia was identified in only 2% of patients initially. The prevalence of intestinal parasites increased with age, both among inpatients and comparison subjects with less severe grades of malnutrition. There did not appear to be important differences in the parasite loads or prevalences between the 2 groups. Twenty-one inpatients died; deaths were more common in younger children. The cause of death was most frequently related to infections. The identification and appropriate treatment of infections must be considered a major component of the rehabilitation of severely malnourished children. © 1981 Pergamon Press Ltd.