Background: Complete Congenital Heart Block (CCHB) is a rare disease of the newborn that carries significant morbidity and mortality. CCHB can be diagnosed early or late in life. In newborns, it is usually associated with maternal autoantibodies or a congenital cardiac structural abnormality. The most common presentation of CCHB is bradycardia that can be diagnosed by an electrocardiogram. Results: This is a case report of a male infant born to a mother with an autoimmune disease, Systemic Lupus Erythematosus (SLE), who was found to have third degree heart block at birth. Conclusion: Early diagnosis and prompt management of the case is important for a better prog­nosis and prevention of associated complications. Neonates with CCHB should be managed at a tertiary care center and the only definite treatment is insertion of a pacemaker. Moreover, prenatal diagnosis and specific obstetric counseling of pregnant women with SLE along with careful monitoring with serial ultrasonography and echocardiography are of paramount importance in prevention of the disease in subsequent offspring.

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Drug-induced immune hemolytic anemia (DIIHA) is a rare adverse reaction that causes secondary autoimmune hemolytic anemia in susceptible patients. Drug-induced antibodies and nonimmunological protein absorption are the known mechanisms associated with DIIHA. The two most common reported antibiotics to cause drug dependent antibodies are cephalosporin and penicillin. The author reports two rare cases of DIIHA. The first case is a middle-aged woman clinically diagnosed with community-acquired pneumonia, which develops hemolytic anemia secondary to ceftriaxone. The second case is an elderly gentleman who developed DIIHA secondary to piperacillin–tazobactam that started managing gastrostomy site infection. Both patients had hypoxemia and shortness of breath secondary to drop in hemoglobin, but the outcome was uneventful. Antibiotic-induced hemolytic anemia can develop as early as 2 days after starting the antibiotic. Therefore, early diagnosis and discontinuation of the offending agent can prevent poor prognosis.

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