guias/oftalmologia.html

<div id="celulitis_preseptal_orbitaria" class="treatment-card bg-white rounded-lg shadow-sm p-5 border border-gray-200 mb-6">
  <h2 class="text-base font-bold text-gray-800 mb-3 flex items-center gap-2"><i class="fas fa-eye-slash text-red-500 fa-fw"></i> Celulitis Preseptal y Orbitaria</h2>
  <div class="mb-4">
    <h3 class="text-base font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500 fa-fw"></i> Etiología Frecuente</h3>
    <ul class="list-disc list-outside ml-5 text-base text-gray-700 space-y-1">
      <li>Streptococcus spp, Staphylococcus spp</li>
      <li>Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, anaerobios</li>
    </ul>
  </div>
  <h3 class="text-base font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-syringe text-blue-500 fa-fw"></i> Tratamiento Empírico IV</h3>
  <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-blue-600">
    <div class="treatment-title text-base font-semibold text-blue-800 mb-1.5 flex items-center gap-2"><i class="fas fa-check-circle text-green-500 fa-fw"></i> Elección</div>
    <p class="text-base text-gray-700">Ceftriaxona 2 g IV c/12 h + Cloxacilina 2 g IV c/4-6 h.</p>
  </div>
  <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-blue-600">
    <div class="treatment-title text-base font-semibold text-blue-800 mb-1.5 flex items-center gap-2"><i class="fas fa-allergies text-orange-500 fa-fw"></i> Alergia Beta-lactámicos</div>
    <p class="text-base text-gray-700">Vancomicina 1 g IV c/12 h + Levofloxacino 750 mg IV/24 h o Clindamicina 600-900 mg IV c/8 h o Linezolid 600 mg IV c/12 h.</p>
  </div>
  <div class="note-box bg-amber-50 border-l-4 border-amber-500 p-3 mt-4 rounded-r-lg">
    <div class="note-title text-base font-semibold text-amber-800 mb-1.5 flex items-center gap-2"><i class="fas fa-notes-medical text-yellow-500 fa-fw"></i> Observaciones</div>
    <ul class="list-disc list-outside ml-5 text-base text-gray-700 space-y-1">
      <li>Hospitalización y antibioterapia IV inmediata.</li>
      <li>Pruebas: hemograma, bioquímica, cultivo conjuntival, TC/RM de órbita.</li>
      <li>Medidas de soporte: AINEs, compresas frías, elevación de cabeza, control glucemia.</li>
    </ul>
  </div>
</div>

<div id="endoftalmitis" class="treatment-card bg-white rounded-lg shadow-sm p-5 border border-gray-200 mb-6">
  <h2 class="text-base font-bold text-gray-800 mb-3 flex items-center gap-2"><i class="fas fa-eye-dropper text-purple-600 fa-fw"></i> Endoftalmitis</h2>
  <div class="mb-4">
    <h3 class="text-base font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-info-circle text-blue-500 fa-fw"></i> Clasificación</h3>
    <ul class="list-disc list-outside ml-5 text-base text-gray-700 space-y-1">
      <li>Exógena (tras cirugía/intravítreo) vs Endógena</li>
      <li>Aguda (&lt;6 sem) vs Crónica (&gt;6 sem)</li>
    </ul>
  </div>
  <h3 class="text-base font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription text-blue-500 fa-fw"></i> Tratamiento Intravitreo</h3>
  <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-purple-600">
    <div class="treatment-title text-base font-semibold text-purple-800 mb-1.5 flex items-center gap-2"><i class="fas fa-check-circle text-green-500 fa-fw"></i> Elección</div>
    <p class="text-base text-gray-700">Vancomicina 1 mg/0.1 ml + Ceftazidima 2 mg/0.1 ml.</p>
  </div>
  <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-purple-600">
    <div class="treatment-title text-base font-semibold text-purple-800 mb-1.5 flex items-center gap-2"><i class="fas fa-allergies text-orange-500 fa-fw"></i> Alergia Beta-lactámicos</div>
    <p class="text-base text-gray-700">Amikacina 0.4 mg/0.1 ml intravítrea.</p>
  </div>
  <div class="note-box bg-amber-50 border-l-4 border-amber-500 p-3 mt-4 rounded-r-lg">
    <div class="note-title text-base font-semibold text-amber-800 mb-1.5 flex items-center gap-2"><i class="fas fa-notes-medical text-yellow-500 fa-fw"></i> Observaciones</div>
    <ul class="list-disc list-outside ml-5 text-base text-gray-700 space-y-1">
      <li>Agregar anfotericina B o voriconazol intravítreo si hongos.</li>
      <li>Posible vitrectomía si agudeza ≤ movimiento de manos.</li>
      <li>Añadir terapia tópica/oral según evolución y antibiograma.</li>
    </ul>
  </div>
</div>

<div id="queratitis_bacteriana" class="treatment-card bg-white rounded-lg shadow-sm p-5 border border-gray-200 mb-6">
  <h2 class="text-base font-bold text-gray-800 mb-3 flex items-center gap-2"><i class="fas fa-bacterium text-blue-700 fa-fw"></i> Queratitis Bacteriana</h2>
  <div class="mb-4">
    <h3 class="text-base font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500 fa-fw"></i> Etiología y Gravedad</h3>
    <ul class="list-disc list-outside ml-5 text-base text-gray-700 space-y-1">
      <li>+ Leve: Staph. epi, S. aureus, Strep spp.</li>
      <li>+ Grave: Pseudomonas (LDC), Neisseria, Bacillus.</li>
    </ul>
  </div>
  <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-green-600">
    <div class="treatment-title text-base font-semibold text-green-800 mb-1.5 flex items-center gap-2"><i class="fas fa-thermometer-quarter text-yellow-500 fa-fw"></i> Leve</div>
    <p class="text-base text-gray-700">Moxifloxacino 5 mg/ml colirio 2 gotas c/8 h. LDC: Ofloxacino 3 mg/ml o Ciprofloxacino 3 mg/ml c/8 h.</p>
  </div>
  <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-red-600">
    <div class="treatment-title text-base font-semibold text-red-800 mb-1.5 flex items-center gap-2"><i class="fas fa-thermometer-full text-red-500 fa-fw"></i> Grave</div>
    <p class="text-base text-gray-700">Ceftazidima 50 mg/ml + Tobramicina 20 mg/ml, 2 gotas c/1 h 24-48 h, luego reducir según evolución. Asociar Moxifloxacino oral 400 mg/24 h si extension.</p>
  </div>
  <div class="note-box bg-amber-50 border-l-4 border-amber-500 p-3 mt-4 rounded-r-lg">
    <div class="note-title text-base font-semibold text-amber-800 mb-1.5 flex items-center gap-2"><i class="fas fa-notes-medical text-yellow-500 fa-fw"></i> Observaciones</div>
    <ul class="list-disc list-outside ml-5 text-base text-gray-700 space-y-1">
      <li>Evitar corticoides hasta 24-48 h tras antibiótico.</li>
      <li>Diagnóstico: clínico y raspado corneal si indica.</li>
    </ul>
  </div>
</div>

<div id="queratitis_viral" class="treatment-card bg-white rounded-lg shadow-sm p-5 border border-gray-200 mb-6">
  <h2 class="text-base font-bold text-gray-800 mb-3 flex items-center gap-2"><i class="fas fa-virus text-purple-600 fa-fw"></i> Queratitis Vírica</h2>
  <p class="text-base text-gray-700 mb-4">Incluye epitelial (dendrítica), neurotrófica, estromal inmune/necrotizante, endotelitis y uveítis anterior. Etiologías: VHS y VVZ.</p>
  <div class="mt-4 space-y-4">
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-blue-500">
      <div class="treatment-title text-base font-semibold text-blue-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-blue-600 fa-fw"></i> Epitelial (dendrítica)</div>
      <p class="text-base text-gray-700">Aciclovir 3% pomada 5 v/d + colirio antibiótico (Tobramicina/Moxifloxacino). Ciclopéjico 1% si dolor.</p>
    </div>
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-teal-500">
      <div class="treatment-title text-base font-semibold text-teal-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-teal-600 fa-fw"></i> Neurotrófica</div>
      <p class="text-base text-gray-700">Suero autólogo 1 got a3v/d. Doxiciclina 100 mg/d. Corticoides tópicos + adyuvancia plasmática.</p>
    </div>
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-yellow-500">
      <div class="treatment-title text-base font-semibold text-yellow-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-yellow-600 fa-fw"></i> Estromal inmune/necrotizante</div>
      <p class="text-base text-gray-700">Aciclovir tópico + corticoides tópicos. Antivirales orales y profilaxis antibiótica. Ciclopéjico si uveítis.</p>
    </div>
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-indigo-500">
      <div class="treatment-title text-base font-semibold text-indigo-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-indigo-600 fa-fw"></i> Endotelitis/Uveítis Anterior</div>
      <p class="text-base text-gray-700">Aciclovir 3% + corticoides tópicos (prednisolona), antivirales orales (aciclovir/valaciclovir). Profilaxis prolongada 6-12 meses.</p>
    </div>
  </div>
</div>

<div id="queratitis_fungica" class="treatment-card bg-white rounded-lg shadow-sm p-5 border border-gray-200 mb-6">
  <h2 class="text-base font-bold text-gray-800 mb-3 flex items-center gap-2"><i class="fas fa-spa text-green-700 fa-fw"></i> Queratitis Fúngica</h2>
  <p class="text-base text-gray-700 mb-4">Causadas por hongos filamentosos (Aspergillus, Fusarium) o levaduras (Candida).</p>
  <div class="mt-4 space-y-4">
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-red-500">
      <div class="treatment-title text-base font-semibold text-red-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-red-600 fa-fw"></i> Filamentosos</div>
      <p class="text-base text-gray-700">Natamicina 5% colirio: 1 got c/1 h 24 h, luego progresivo c/2 h (4-6 sem). Alternativa Voriconazol 1% + vía oral.</p>
    </div>
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-blue-500">
      <div class="treatment-title text-base font-semibold text-blue-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-blue-600 fa-fw"></i> Levaduras</div>
      <p class="text-base text-gray-700">Anfotericina B 0.25% colirio: pauta similar. Alternativa Fluconazol tópico o flucitosina.</p>
    </div>
    <div class="treatment-option bg-white rounded-lg p-3 my-3 border-l-4 border-gray-500">
      <div class="treatment-title text-base font-semibold text-gray-800 mb-1.5 flex items-center gap-2"><i class="fas fa-prescription text-gray-600 fa-fw"></i> Recalcitrante / Mixta</div>
      <p class="text-base text-gray-700">Natamicina + Anfotericina B; valorar inyecciones subconjuntivales/intrastromales y adjuntos de povidona o desbridamiento.</p>
    </div>
  </div>
</div>