[Simultaneous botulism in two brothers addicted to cocaine].

INTRODUCTION

Botulism is currently an uncommon disease in which the botulinum toxin causes a progressive muscular paralysis that can lead to the death due to a failure of respiratory muscles.

CLINICAL CASE: Two brothers, both addicted to cocaine, came to the casualty department because of a decrease of near visual acuity and bilateral mydriasis. Two days later, they developed eyelid ptosis, asymmetric dysfunction of the extraocular muscles and vomiting.

DISCUSSION: The presence of a paralysis of accommodation, with bilateral mydriasis that reacts to pilocarpine, makes it necessary to consider botulism as a possible cause.