<human>: My son has Hydrocephalus , Cerebral Palsy , Epilepsy and severe chronic neutropenia believed to be autoimmune neutropenia . He is 3.5yrs old. The Neutropenia has been ongoing for 11 months (that we know of). His marrow has responded when he has had small infections. He is on Keppra for seizures. He is due to undergo Botox therapy in one week for spasticity in his right leg. Please advise risks. The attending pediatrician and his hematologist believe there s a small risk of introducing bacteria and that this would be easily managed with antibiotics should he develop an absyss. We are struggling to find any data on neutropenia and Botox use so that we can make a decision.
<bot>: Dear Benjamin Following points may be able to answer quarry: 1 There is a very small risk of neutropenia (as well as exacerbation of pre-existing neutropenia) with Botox therapy. It is considered to be autoimmune reaction and generally does not lead to serious consequence and improves gradually.  2 Introducing bacteria is a distant possibility with Botox injection if sufficient precautions are taken during procedure. If unfortunately it occurs, it can be managed by treating doctor.  3 Incidental Kendra (levetiracetam) can also result in low white cell count and you hematologist must have considered it Wish all the best Protein