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Browse files- proa/bacteremia_cateter.html +93 -0
- proa/digestivo.html +126 -0
- proa/digestivo_pediatrico.html +124 -0
- proa/embarazadas.html +284 -0
- proa/endocarditis_infecciosa.html +109 -0
- proa/ginecologia.html +140 -0
- proa/infecciones_tracto_urinario_adultos.html +278 -0
- proa/neutropenia.html +180 -0
- proa/oftalmologia.html +147 -0
- proa/orl.html +192 -0
- proa/orl_pediatrico.html +109 -0
- proa/osteoarticular.html +167 -0
- proa/osteoarticulares_pediatrico.html +120 -0
- proa/piel_partes_blandas.html +153 -0
- proa/proa.html +796 -0
- proa/respiratorio.html +126 -0
- proa/respiratorio_pediatrico.html +152 -0
- proa/sindrome_febril_agudo_pediatrico.html +125 -0
- proa/sistema_nervioso_central_pediatrico.html +124 -0
- proa/urologia_pediatrica.html +118 -0
proa/bacteremia_cateter.html
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<!DOCTYPE html>
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<html lang="es">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>Guía PROA - Bacteriemia Asociada a Catéter</title>
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<script src="https://cdn.tailwindcss.com"></script>
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<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
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<style>
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@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
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body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
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.treatment-card { transition: all 0.3s ease; }
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.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1),0 4px 6px -2px rgba(0,0,0,0.05); }
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.pathogen-list { display:flex;flex-wrap:wrap;gap:0.5rem;margin:0.5rem 0; }
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.pathogen-item { background-color:#e0f2fe;color:#0369a1;padding:0.25rem 0.75rem;border-radius:9999px;font-size:0.875rem;font-weight:500; }
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.treatment-option { background:white;border-radius:0.5rem;padding:1rem;margin:1rem 0 0.5rem 0;border-left:4px solid #3b82f6; }
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.treatment-title { font-weight:600;color:#1e40af;margin-bottom:0.5rem;display:flex;align-items:center;gap:0.5rem; }
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.note-box { background:#fffbeb;border-left:4px solid #f59e0b;padding:0.75rem;margin:1rem 0;border-radius:0 0.5rem 0.5rem 0; }
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.note-title { font-weight:600;color:#92400e;display:flex;align-items:center;gap:0.5rem;margin-bottom:0.5rem; }
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.custom-select { background-image:url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e");background-position:right 0.5rem center;background-repeat:no-repeat;background-size:1.5em 1.5em; }
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ul { list-style-position:outside;margin-left:1.25rem; }
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li { margin-bottom:0.25rem; }
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</style>
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</head>
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<body class="min-h-screen bg-gray-50">
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<div class="max-w-4xl mx-auto px-4 py-8">
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<div class="flex items-center gap-3 mb-6">
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<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-procedures text-2xl"></i></div>
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<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Bacteriemia Asociada a Catéter</h1>
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</div>
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<div class="bg-white rounded-xl shadow-md p-6 mb-6">
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<label for="diagSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-blue-500"></i> Clasificación</label>
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<select id="diagSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
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<option value="">-- Selecciona una categoría --</option>
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<option value="corta_sin_candida">Corta duración sin riesgo de Cándida</option>
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<option value="corta_con_candida">Corta duración con riesgo de Cándida</option>
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<option value="larga_sin_candida">Larga duración sin riesgo de Cándida</option>
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<option value="larga_con_candida">Larga duración con riesgo de Cándida</option>
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</select>
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</div>
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<div id="result" class="space-y-6"></div>
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<div id="storage" class="hidden">
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<!-- Corta sin Candida -->
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<div id="corta_sin_candida" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-vial text-red-500"></i> Corta duración sin riesgo de Cándida</h2>
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<div class="mb-4"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología frecuente</h3><div class="pathogen-list"><span class="pathogen-item">S. epidermidis</span><span class="pathogen-item">Coagulasa-negativos</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Enterococcus spp.</span><span class="pathogen-item">Enterobacterias</span><span class="pathogen-item">P. aeruginosa</span></div></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Vancomicina 15 mg/kg IV cada 12 h* + Ceftazidima 2 g IV cada 8 h o Piperacilina-Tazobactam 4,5 g IV cada 6 h.</p></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa (alergia BL)</div><p class="text-gray-700">Vancomicina 15 mg/kg IV cada 12 h* + Aztreonam 2 g IV cada 8 h o Amikacina 20 mg/kg/día IV.</p></div>
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<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones</div><ul><li>Extraer hemocultivos de todas las luces y de vena periférica.</li><li>Retirar catéter periférico siempre; central si no necesario o complicaciones.</li><li>Tratamiento en domicilio posible con mismas pautas.</li><li>*Solicitar niveles de vancomicina desde tercera dosis.</li></ul></div>
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</div>
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<!-- Corta con Candida -->
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<div id="corta_con_candida" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-vial text-red-500"></i> Corta duración con riesgo de Cándida</h2>
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<div class="mb-4"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología frecuente</h3><div class="pathogen-list"><span class="pathogen-item">(previas)</span><span class="pathogen-item">+ Cándida spp.</span></div></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-star text-purple-500"></i> Shock o riesgo elevado</div><p class="text-gray-700">Anidulafungina 200 mg IV primer día, luego 100 mg IV/24 h + pauta antibacteriana estándar (Vancomicina + Ceftazidima o Piperacilina-Tazobactam).</p></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-star text-purple-500"></i> Resto de casos</div><p class="text-gray-700">Fluconazol 800 mg IV en dosis de carga, luego 400 mg IV/24 h + antibacteriana estándar.</p></div>
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<div class="note-box"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Factores de riesgo Candida</div><ul><li>Sepsis grave o shock</li><li>Nutrición parenteral, cirugía abdominal, pancreatitis</li><li>Neoplasias, neutropenia, trasplantes</li><li>Colonización previa, sondas femorales, UCI</li></ul></div>
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</div>
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<!-- Larga sin Candida -->
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<div id="larga_sin_candida" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-lock text-blue-500"></i> Larga duración sin riesgo de Cándida</h2>
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<div class="mb-4"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología frecuente</h3><div class="pathogen-list"><span class="pathogen-item">S. epidermidis</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Enterococcus spp.</span><span class="pathogen-item">Enterobacterias</span><span class="pathogen-item">P. aeruginosa</span></div></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Vancomicina 15 mg/kg IV c/12 h* + Ceftazidima 2 g IV c/8 h o Piperacilina-Tazobactam 4,5 g IV c/6 h.</p></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa (alergia BL)</div><p class="text-gray-700">Vancomicina 15 mg/kg IV c/12 h* + Aztreonam 2 g IV c/8 h o Amikacina 20 mg/kg/día IV.</p></div>
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<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones</div><ul><li>Considerar sellado de catéter si no se retira.</li><li>Hemocultivos de control cada 72 h hasta negativizar.</li><li>Retirar si persiste bacteriemia >72 h.</li></ul></div>
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</div>
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<!-- Larga con Candida -->
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<div id="larga_con_candida" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-lock text-blue-500"></i> Larga duración con riesgo de Cándida</h2>
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<div class="mb-4"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología frecuente</h3><div class="pathogen-list"><span class="pathogen-item">(previas)</span><span class="pathogen-item">+ Cándida spp.</span></div></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-star text-purple-500"></i> Shock o riesgo elevado</div><p class="text-gray-700">Anidulafungina 200 mg IV primer día, luego 100 mg IV/24 h + antibacteriana estándar.</p></div>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-star text-purple-500"></i> Resto de casos</div><p class="text-gray-700">Fluconazol 800 mg IV dosis de carga, luego 400 mg IV/24 h + antibacteriana estándar.</p></div>
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</div>
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</div>
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<script>
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const sel = document.getElementById('diagSelector');
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const res = document.getElementById('result');
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const store = document.getElementById('storage');
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sel.addEventListener('change', () => {
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res.innerHTML = '';
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const id = sel.value;
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if (!id) return;
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const node = store.querySelector('#' + id);
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if (node) res.appendChild(node.cloneNode(true));
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});
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</script>
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<div class="mt-12 text-center text-sm text-gray-500">
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<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
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<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
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</div>
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</div>
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</body>
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</html>
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proa/digestivo.html
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<!DOCTYPE html>
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<html lang="es">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>Guía PROA - Digestivo</title>
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<script src="https://cdn.tailwindcss.com"></script>
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<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
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<style>
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@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
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body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
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.treatment-card { transition: all 0.3s ease; }
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.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1),0 4px 6px -2px rgba(0,0,0,0.05); }
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.pathogen-list { display:flex;flex-wrap:wrap;gap:0.5rem;margin:0.5rem 0; }
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.pathogen-item { background:#e0f2fe;color:#0369a1;padding:0.25rem 0.75rem;border-radius:9999px;font-size:0.875rem;font-weight:500; }
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.treatment-option { background:white;border-radius:0.5rem;padding:1rem;margin:1rem 0 0.5rem 0;border-left:4px solid #3b82f6; }
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.treatment-title { font-weight:600;color:#1e40af;margin-bottom:0.5rem;display:flex;align-items:center;gap:0.5rem; }
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.note-box { background:#fffbeb;border-left:4px solid #f59e0b;padding:0.75rem;margin:1rem 0;border-radius:0 0.5rem 0.5rem 0; }
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.note-title { font-weight:600;color:#92400e;display:flex;align-items:center;gap:0.5rem;margin-bottom:0.5rem; }
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.custom-select { background-image:url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e");background-position:right 0.5rem center;background-repeat:no-repeat;background-size:1.5em 1.5em; }
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ul { list-style-position:outside;margin-left:1.25rem; }
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li { margin-bottom:0.25rem; }
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</style>
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</head>
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<body class="min-h-screen bg-gray-50">
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<div class="max-w-4xl mx-auto px-4 py-8">
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<div class="flex items-center gap-3 mb-6">
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| 28 |
+
<div class="bg-green-600 p-2 rounded-lg text-white"><i class="fas fa-stomach text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Digestivo</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="digSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-green-500"></i> Selecciona módulo</label>
|
| 33 |
+
<select id="digSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-green-500 focus:border-green-500">
|
| 34 |
+
<option value="">-- Elige un módulo --</option>
|
| 35 |
+
<option value="esofagitis">Esofagitis infecciosa</option>
|
| 36 |
+
<option value="gastroenteritis">Gastroenteritis aguda</option>
|
| 37 |
+
<option value="colitis_cd">Colitis por C. difficile</option>
|
| 38 |
+
<option value="colangitis">Colangitis</option>
|
| 39 |
+
<option value="colecistitis_simple">Colecistitis aguda simple</option>
|
| 40 |
+
<option value="colecistitis_comp">Colecistitis complicada</option>
|
| 41 |
+
<option value="peritonitis">Peritonitis bacteriana espontánea</option>
|
| 42 |
+
</select>
|
| 43 |
+
</div>
|
| 44 |
+
<div id="result" class="space-y-6"></div>
|
| 45 |
+
<div id="storage" class="hidden">
|
| 46 |
+
<!-- Esofagitis -->
|
| 47 |
+
<div id="esofagitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 48 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-virus text-red-500"></i> Esofagitis infecciosa</h2>
|
| 49 |
+
<h3 class="font-semibold text-gray-700 mt-4">Fúngica (Candidiasis)</h3>
|
| 50 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Fluconazol 40 mg dosis única, seguido de 200-400 mg/24 h VO.</p></div>
|
| 51 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Voriconazol 200 mg/12 h VO.</p></div>
|
| 52 |
+
<h3 class="font-semibold text-gray-700 mt-4">Vírica (inmunodeprimidos)</h3>
|
| 53 |
+
<div class="treatment-option"><div class="treatment-title">VHS</div><p>Aciclovir 5-10 mg/kg/8 h IV o 400 mg 5 × día VO.</p></div>
|
| 54 |
+
<div class="treatment-option"><div class="treatment-title">CMV</div><p>Ganciclovir 5 mg/kg/12 h IV → Valganciclovir 900 mg/24 h VO.</p></div>
|
| 55 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Duración: Candida/VHS 14–21 días; CMV 21–28 días.</li><li>Si no responde, endoscopia y biopsia.</li></ul></div>
|
| 56 |
+
</div>
|
| 57 |
+
<!-- Gastroenteritis -->
|
| 58 |
+
<div id="gastroenteritis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 59 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-virus text-yellow-600"></i> Gastroenteritis aguda</h2>
|
| 60 |
+
<h3 class="font-semibold text-gray-700 mt-4">No inflamatoria</h3>
|
| 61 |
+
<div class="note-box"><div class="note-title">Manejo</div><ul><li>Tratamiento sintomático: dieta, evitar lácteos.</li><li>Estudios: coprocultivo y detección viral.</li></ul></div>
|
| 62 |
+
<h3 class="font-semibold text-gray-700 mt-4">Inflamatoria</h3>
|
| 63 |
+
<div class="pathogen-list"><span class="pathogen-item">Campylobacter</span><span class="pathogen-item">Salmonella</span><span class="pathogen-item">Shigella</span><span class="pathogen-item">E. coli ent.</span></div>
|
| 64 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Azitromicina 500 mg/24 h IV/VO 3–5 días.</p></div>
|
| 65 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ciprofloxacino 500 mg/12 h IV 5–7 días.</p></div>
|
| 66 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Solo antibiótico si: diarrea sanguinolenta, SRIS, >65 años, inmunodeprimidos, viajero grave.</li></ul></div>
|
| 67 |
+
</div>
|
| 68 |
+
<!-- Colitis C. difficile -->
|
| 69 |
+
<div id="colitis_cd" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 70 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bacteria text-purple-500"></i> Colitis por C. difficile</h2>
|
| 71 |
+
<h3 class="font-semibold text-gray-700 mt-4">Primer episodio leve</h3>
|
| 72 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Vancomicina 125 mg/6 h VO 10 días.</p></div>
|
| 73 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Metronidazol 500 mg/8 h VO 10 días.</p></div>
|
| 74 |
+
<div class="treatment-option"><div class="treatment-title">Fidaxomicina</div><p>200 mg/12 h VO 10 días (vulnerable/recurrencia).</p></div>
|
| 75 |
+
<h3 class="font-semibold text-gray-700 mt-4">Episodios recurrencias</h3>
|
| 76 |
+
<div class="note-box"><div class="note-title">Ver protocolos de recidiva</div><ul><li>Pauta descendente de vancomicina o fidaxomicina ± bezlotoxumab.</li><li>Fecal microbiota transplant si ≥3 recidivas.</li></ul></div>
|
| 77 |
+
</div>
|
| 78 |
+
<!-- Colangitis -->
|
| 79 |
+
<div id="colangitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 80 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-biliary text-blue-500"></i> Colangitis</h2>
|
| 81 |
+
<h3 class="font-semibold text-gray-700 mt-4">Leve-moderada</h3>
|
| 82 |
+
<div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Enterobacterias</span></div>
|
| 83 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ceftriaxona 1–2 g/24 h IV o cefotaxima 2 g/8 h IV.</p></div>
|
| 84 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa (BLEE)</div><p>Ertapenem 1 g/24 h IV.</p></div>
|
| 85 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Drenaje biliar precoz (CPRE <48–72 h).</li><li>Duración según evolución; suspender tras 72 h afebril.</li></ul></div>
|
| 86 |
+
<h3 class="font-semibold text-gray-700 mt-4">Grave</h3>
|
| 87 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Meropenem 1 g/8 h o Piperacilina/Tazobactam 4,5 g/6 h IV.</p></div>
|
| 88 |
+
</div>
|
| 89 |
+
<!-- Colecistitis simple -->
|
| 90 |
+
<div id="colecistitis_simple" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 91 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-gallbladder text-yellow-600"></i> Colecistitis aguda simple</h2>
|
| 92 |
+
<div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Enterobacterias</span></div>
|
| 93 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Cefotaxima 1–2 g/8 h IV o ceftriaxona 1–2 g/24 h IV.</p></div>
|
| 94 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Aztreonam 1–2 g/8 h IV o Amikacina 15 mg/kg/día IV.</p></div>
|
| 95 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Colecistectomía precoz (48–72 h).</li><li>Duración ATB: 72 h post-colecistectomía o 7–10 días.</li></ul></div>
|
| 96 |
+
</div>
|
| 97 |
+
<!-- Colecistitis complicada -->
|
| 98 |
+
<div id="colecistitis_comp" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 99 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-gallbladder text-red-600"></i> Colecistitis complicada</h2>
|
| 100 |
+
<div class="pathogen-list"><span class="pathogen-item">Enterobacterias</span><span class="pathogen-item">Enterococcus</span><span class="pathogen-item">P. aeruginosa</span></div>
|
| 101 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Piperacilina/Tazobactam 4 g/6 h IV ± Meropenem 1–2 g/8 h si sepsis.</p></div>
|
| 102 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Colecistectomía urgente si absceso o gangrena.</li><li>Duración: 14 días IV.</li></ul></div>
|
| 103 |
+
</div>
|
| 104 |
+
<!-- Peritonitis -->
|
| 105 |
+
<div id="peritonitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 106 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-procedures text-teal-500"></i> Peritonitis bacteriana espontánea</h2>
|
| 107 |
+
<h3 class="font-semibold text-gray-700 mt-4">Comunitaria</h3>
|
| 108 |
+
<div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Klebsiella</span></div>
|
| 109 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ceftriaxona 2 g/24 h IV o cefotaxima 2 g/8 h IV.</p></div>
|
| 110 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Levofloxacino 750 mg/24 h IV o Aztreonam 2 g/8 h IV.</p></div>
|
| 111 |
+
<h3 class="font-semibold text-gray-700 mt-4">Nosocomial o con riesgo</h3>
|
| 112 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Piperacilina/Tazobactam 4 g/8 h IV ± Linezolid 600 mg/12 h IV.</p></div>
|
| 113 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Duración: 5–7 días (ajustar).</li><li>Paracentesis diagnóstica y cultivos.</li><li>Albúmina profiláctica en cirróticos.</li></ul></div>
|
| 114 |
+
</div>
|
| 115 |
+
</div>
|
| 116 |
+
<script>
|
| 117 |
+
const sel=document.getElementById('digSelector'),res=document.getElementById('result'),store=document.getElementById('storage');
|
| 118 |
+
sel.addEventListener('change',()=>{res.innerHTML='';const id=sel.value; if(!id)return; const node=store.querySelector('#'+id); if(node)res.appendChild(node.cloneNode(true));});
|
| 119 |
+
</script>
|
| 120 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 121 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 122 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 123 |
+
</div>
|
| 124 |
+
</div>
|
| 125 |
+
</body>
|
| 126 |
+
</html>
|
proa/digestivo_pediatrico.html
ADDED
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@@ -0,0 +1,124 @@
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| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Digestivo PED</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body{font-family:'Montserrat',sans-serif;background:#f8fafc;}
|
| 12 |
+
.treatment-card{transition:all .3s ease;} .treatment-card:hover{transform:translateY(-2px);box-shadow:0 10px 15px -3px rgba(0,0,0,.1),0 4px 6px -2px rgba(0,0,0,.05);}
|
| 13 |
+
.custom-select{background:url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e") no-repeat right .5rem center/1.5em 1.5em;}
|
| 14 |
+
ul{margin-left:1.25rem;} li{margin-bottom:.25rem;}
|
| 15 |
+
.treatment-option{background:#fff;border-radius:.5rem;padding:1rem;margin:1rem 0 .5rem 0;border-left:4px solid #3b82f6;}
|
| 16 |
+
.treatment-title{font-weight:600;color:#1e40af;margin-bottom:.5rem;display:flex;align-items:center;gap:.5rem;}
|
| 17 |
+
.note-box{background:#fffbeb;border-left:4px solid #f59e0b;padding:.75rem;margin:1rem 0;border-radius:0 .5rem .5rem 0;}
|
| 18 |
+
.note-title{font-weight:600;color:#92400e;display:flex;align-items:center;gap:.5rem;margin-bottom:.5rem;}
|
| 19 |
+
.pathogen-list{display:flex;flex-wrap:wrap;gap:.5rem;margin:.5rem 0;}
|
| 20 |
+
.pathogen-item{background:#e0f2fe;color:#0369a1;padding:.25rem .75rem;border-radius:9999px;font-size:.875rem;font-weight:500;}
|
| 21 |
+
</style>
|
| 22 |
+
</head>
|
| 23 |
+
<body class="min-h-screen bg-gray-50">
|
| 24 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 25 |
+
<div class="flex items-center gap-3 mb-6">
|
| 26 |
+
<div class="bg-green-600 p-2 rounded-lg text-white"><i class="fas fa-stomach text-2xl"></i></div>
|
| 27 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Digestivo Pediátrico</h1>
|
| 28 |
+
</div>
|
| 29 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 30 |
+
<label for="diagSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-green-500"></i> Patógeno / Síndrome</label>
|
| 31 |
+
<select id="diagSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-green-500 focus:border-green-500">
|
| 32 |
+
<option value="">-- Selecciona --</option>
|
| 33 |
+
<option value="campylobacter">Campylobacter spp.</option>
|
| 34 |
+
<option value="salmonella">Salmonella spp.</option>
|
| 35 |
+
<option value="c_difficile">Clostridioides difficile</option>
|
| 36 |
+
<option value="ehec">E. coli enterohemorrágico (O157:H7)</option>
|
| 37 |
+
<option value="ecet">E. coli enterotoxigénico</option>
|
| 38 |
+
<option value="shigella">Shigella</option>
|
| 39 |
+
<option value="yersinia">Yersinia</option>
|
| 40 |
+
<option value="virus">Virus entéricos</option>
|
| 41 |
+
<option value="giardia">Giardia lamblia</option>
|
| 42 |
+
</select>
|
| 43 |
+
</div>
|
| 44 |
+
<div id="result" class="space-y-6"></div>
|
| 45 |
+
<div id="storage" class="hidden">
|
| 46 |
+
<!-- Campylobacter -->
|
| 47 |
+
<div id="campylobacter" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 48 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bug text-red-500"></i> Campylobacter spp.</h2>
|
| 49 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea inflamatoria</span><span class="pathogen-item">Toxiinfección alimentaria</span></div>
|
| 50 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Azitromicina 10 mg/kg/24 h VO, 3 días (máx 500 mg/día) o Cefotaxima 100-200 mg/kg/día IV en 3-4 dosis, 3-5 días (máx 6 g/día) si bacteriemia.</p></div>
|
| 51 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ciprofloxacino 15 mg/kg/12 h VO/IV, 3-5 días (máx 500 mg/12 h).</p></div>
|
| 52 |
+
<div class="note-box"><div class="note-title">Indicaciones / Comentarios</div><ul><li>Diarrea >7 días, GEA grave, reducir contagio institucional.</li><li>Generalmente autolimitada; antibiótico más eficaz primeros 3 días.</li></ul></div>
|
| 53 |
+
</div>
|
| 54 |
+
<!-- Salmonella -->
|
| 55 |
+
<div id="salmonella" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 56 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bug text-red-500"></i> Salmonella spp.</h2>
|
| 57 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea inflamatoria</span><span class="pathogen-item">Toxiinfección alimentaria</span></div>
|
| 58 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Cefixima 4-5 mg/kg/12 h VO, 5 días (máx 400 mg/día) o Cefotaxima 100-200 mg/kg/día IV en 3-4 dosis, 3-5 días (máx 6 g).</p></div>
|
| 59 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ciprofloxacino 15 mg/kg/12 h VO/IV o Cotrimoxazol 5 mg TMP/kg/12 h VO, 3-5 días.</p></div>
|
| 60 |
+
<div class="note-box"><div class="note-title">Indicaciones / Comentarios</div><ul><li>Diarrea >7 días, <3 meses, bacteriemia, inmunosupresión.</li><li>ATB no acorta síntomas; Salmonella typhi siempre tratar.</li></ul></div>
|
| 61 |
+
</div>
|
| 62 |
+
<!-- C. difficile -->
|
| 63 |
+
<div id="c_difficile" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 64 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bacteria text-purple-500"></i> Clostridioides difficile</h2>
|
| 65 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea inflamatoria</span></div>
|
| 66 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Metronidazol 30 mg/kg/día VO en 3-4 dosis, 10 días (máx 750 mg/dosis).</p></div>
|
| 67 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Vancomicina 50 mg/kg/día VO en 4 dosis, 7-14 días (máx 500 mg/dosis).</p></div>
|
| 68 |
+
<div class="note-box"><div class="note-title">Indicaciones / Comentarios</div><ul><li>Tratar si no mejora tras retirar ATB, recaídas o casos graves.</li><li>Reservar vancomicina para ingresados o riesgo recurrencia.</li></ul></div>
|
| 69 |
+
</div>
|
| 70 |
+
<!-- EHEC -->
|
| 71 |
+
<div id="ehec" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 72 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-ban text-red-600"></i> E. coli enterohemorrágico (O157:H7)</h2>
|
| 73 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Contraindicado el uso de antibióticos: aumenta riesgo de SHU.</li></ul></div>
|
| 74 |
+
</div>
|
| 75 |
+
<!-- ECET -->
|
| 76 |
+
<div id="ecet" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 77 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bug text-blue-500"></i> E. coli enterotoxigénico</h2>
|
| 78 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea acuosa</span><span class="pathogen-item">Diarrea del viajero</span></div>
|
| 79 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Azitromicina 10 mg/kg/24 h VO, dosis única, 3-5 días (máx 500 mg/día).</p></div>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ciprofloxacino 15 mg/kg/12 h VO/IV, 3-5 días (máx 500 mg/12 h).</p></div>
|
| 81 |
+
<div class="note-box"><div class="note-title">Indicaciones</div><ul><li>Siempre.</li></ul></div>
|
| 82 |
+
</div>
|
| 83 |
+
<!-- Shigella -->
|
| 84 |
+
<div id="shigella" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 85 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bug text-red-500"></i> Shigella</h2>
|
| 86 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea inflamatoria</span></div>
|
| 87 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Azitromicina 12 mg/kg/24 h VO primer día; luego 6 mg/kg/24 h 4 días (máx 500 mg/día) o Cefotaxima 100-200 mg/kg/día IV en 3-4 dosis, 3-5 días.</p></div>
|
| 88 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ciprofloxacino 15 mg/kg/12 h VO/IV, 3-5 días.</p></div>
|
| 89 |
+
<div class="note-box"><div class="note-title">Indicaciones</div><ul><li>Tratar siempre con cultivo positivo o sospecha fundada.</li></ul></div>
|
| 90 |
+
</div>
|
| 91 |
+
<!-- Yersinia -->
|
| 92 |
+
<div id="yersinia" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 93 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-bug text-red-500"></i> Yersinia</h2>
|
| 94 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea inflamatoria</span></div>
|
| 95 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Cefixima 4-5 mg/kg/12 h VO, 5 días o Cefotaxima 100-200 mg/kg/día IV en 3-4 dosis, 3-5 días.</p></div>
|
| 96 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ciprofloxacino 15 mg/kg/12 h VO/IV, 3-5 días o Cotrimoxazol 5 mg TMP/kg/12 h VO, 3-5 días.</p></div>
|
| 97 |
+
<div class="note-box"><div class="note-title">Indicaciones</div><ul><li>Bacteriemia, enfermedad invasiva, inmunosupresión, GEA grave.</li></ul></div>
|
| 98 |
+
</div>
|
| 99 |
+
<!-- Virus -->
|
| 100 |
+
<div id="virus" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 101 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-virus text-yellow-600"></i> Virus entéricos</h2>
|
| 102 |
+
<div class="pathogen-list"><span class="pathogen-item">Adenovirus</span><span class="pathogen-item">Rotavirus</span><span class="pathogen-item">Astrovirus</span><span class="pathogen-item">Norovirus</span></div>
|
| 103 |
+
<div class="note-box"><div class="note-title">Tratamiento</div><ul><li>No está justificado el uso de antibióticos.</li></ul></div>
|
| 104 |
+
</div>
|
| 105 |
+
<!-- Giardia -->
|
| 106 |
+
<div id="giardia" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 107 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-flask text-green-500"></i> Giardia lamblia</h2>
|
| 108 |
+
<div class="pathogen-list"><span class="pathogen-item">Diarrea no inflamatoria</span></div>
|
| 109 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Metronidazol 5 mg/kg/8 h VO, 7 días (máx 500-750 mg/dosis).</p></div>
|
| 110 |
+
<div class="treatment-option"><div class="treatment-title">Recurrencia</div><p>Metronidazol 10 mg/kg/8 h VO.</p></div>
|
| 111 |
+
<div class="note-box"><div class="note-title">Indicaciones</div><ul><li>Siempre.</li></ul></div>
|
| 112 |
+
</div>
|
| 113 |
+
</div>
|
| 114 |
+
<script>
|
| 115 |
+
const sel=document.getElementById('diagSelector'), res=document.getElementById('result'), store=document.getElementById('storage');
|
| 116 |
+
sel.addEventListener('change',()=>{res.innerHTML='';const id=sel.value; if(!id) return; const node=store.querySelector('#'+id); if(node) res.appendChild(node.cloneNode(true));});
|
| 117 |
+
</script>
|
| 118 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 119 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 120 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 121 |
+
</div>
|
| 122 |
+
</div>
|
| 123 |
+
</body>
|
| 124 |
+
</html>
|
proa/embarazadas.html
ADDED
|
@@ -0,0 +1,284 @@
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Embarazadas</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1),0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right .5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 15 |
+
.treatment-option { background: white; border-radius: .5rem; padding: 1rem; margin: 1rem 0 .5rem; border-left: 4px solid #db2777; }
|
| 16 |
+
.treatment-title { font-weight:600; color:#831843; margin-bottom:.5rem; display:flex; align-items:center; gap:.5rem; }
|
| 17 |
+
.note-box { background:#ffecf0; border-left:4px solid #ec4899; padding:.75rem; margin:1rem 0; border-radius:0 .5rem .5rem 0; }
|
| 18 |
+
.note-title { font-weight:600; color:#831843; display:flex; align-items:center; gap:.5rem; margin-bottom:.5rem; }
|
| 19 |
+
ul { margin-left:1.25rem; } li { margin-bottom:.25rem; }
|
| 20 |
+
optgroup { font-style:italic; }
|
| 21 |
+
</style>
|
| 22 |
+
</head>
|
| 23 |
+
<body class="min-h-screen bg-gray-50">
|
| 24 |
+
<div class="max-w-5xl mx-auto px-4 py-8">
|
| 25 |
+
<div class="flex items-center gap-3 mb-6">
|
| 26 |
+
<div class="bg-pink-600 p-2 rounded-lg text-white"><i class="fas fa-baby text-2xl"></i></div>
|
| 27 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Embarazadas y Puerperio</h1>
|
| 28 |
+
</div>
|
| 29 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 30 |
+
<label for="sel" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-pink-500"></i> Selecciona categoría</label>
|
| 31 |
+
<select id="sel" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-pink-500 focus:border-pink-500">
|
| 32 |
+
<option value="">-- Elige categoría --</option>
|
| 33 |
+
<optgroup label="Infecciones específicas">
|
| 34 |
+
<option value="rpm_term_24h">RPM >37 sem < 24 h</option>
|
| 35 |
+
<option value="rpm_term_gt24h">RPM >37 sem > 24 h</option>
|
| 36 |
+
<option value="rpm_tardio">RPM 34+0–36+6</option>
|
| 37 |
+
<option value="rpm_preterm">RPM 24+0–33+6</option>
|
| 38 |
+
<option value="rpm_previabilidad">RPM < 24+0 (previabilidad)</option>
|
| 39 |
+
<option value="app">Amenaza parto prematuro</option>
|
| 40 |
+
<option value="corioamnionitis">Corioamnionitis</option>
|
| 41 |
+
<option value="fiebre_intraparto">Fiebre intraparto</option>
|
| 42 |
+
<option value="sgb">Presencia SGB</option>
|
| 43 |
+
<option value="cesarea">Cesárea</option>
|
| 44 |
+
<option value="alumbramiento_manual">Alumbramiento manual</option>
|
| 45 |
+
<option value="lesion_esfinter">Lesión esfínter anal 3º/4º grado</option>
|
| 46 |
+
<option value="legrado">Legrado obstétrico</option>
|
| 47 |
+
<option value="cerclaje">Cerclaje cervical</option>
|
| 48 |
+
<option value="mastitis">Mastitis puerperal</option>
|
| 49 |
+
<option value="herida_quirurgica">Infección herida quirúrgica</option>
|
| 50 |
+
<option value="endometritis">Endometritis</option>
|
| 51 |
+
<option value="abscesos">Abscesos intraabdominales</option>
|
| 52 |
+
</optgroup>
|
| 53 |
+
<optgroup label="Infecciones generales">
|
| 54 |
+
<option value="bacteriuria_asint">Bacteriuria asintomática</option>
|
| 55 |
+
<option value="cistitis">Cistitis</option>
|
| 56 |
+
<option value="pielonefritis">Pielonefritis</option>
|
| 57 |
+
<option value="faringoamigdalitis">Faringoamigdalitis</option>
|
| 58 |
+
<option value="bronquitis">Bronquitis</option>
|
| 59 |
+
<option value="gripe">Gripe</option>
|
| 60 |
+
<option value="neumonia">Neumonía comunitaria</option>
|
| 61 |
+
<option value="otitis_externa">Otitis externa</option>
|
| 62 |
+
<option value="otitis_media">Otitis media</option>
|
| 63 |
+
<option value="sinusitis">Sinusitis</option>
|
| 64 |
+
<option value="odontogena">Infección odontógena</option>
|
| 65 |
+
<option value="inf_locales">Piel: impétigo/foliculitis</option>
|
| 66 |
+
<option value="inf_moderadas">Celulitis/erisipela</option>
|
| 67 |
+
<option value="inf_necrotizante">Fascitis necrotizante</option>
|
| 68 |
+
<option value="gastroenteritis">Gastroenteritis</option>
|
| 69 |
+
<option value="colecistitis">Colecistitis/colangitis</option>
|
| 70 |
+
<option value="diverticulitis">Diverticulitis/absceso</option>
|
| 71 |
+
</optgroup>
|
| 72 |
+
</select>
|
| 73 |
+
</div>
|
| 74 |
+
<div id="result" class="space-y-6"></div>
|
| 75 |
+
<div id="store" class="hidden">
|
| 76 |
+
<!-- RPM >37 sem <24h -->
|
| 77 |
+
<div id="rpm_term_24h" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 78 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">RPM término <24 h</h2>
|
| 79 |
+
<p>No infecciosa. Sin cobertura antibiótica si SGB negativo y bolsa rota <24 h. Si inducción o progresión >24 h, pauta SGB:</p>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ampicilina 2 g IV (1ª) + Ampicilina 1 g/4 h IV hasta parto.</p></div>
|
| 81 |
+
<div class="treatment-option"><div class="treatment-title">Alergia</div><p>Clindamicina 900 mg/8 h IV o Vancomicina 1 g/12 h IV.</p></div>
|
| 82 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Duración: durante el parto.</li><li>Finalizar gestación <24 h tras RPM.</li></ul></div>
|
| 83 |
+
</div>
|
| 84 |
+
<!-- RPM >37 sem >24h -->
|
| 85 |
+
<div id="rpm_term_gt24h" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 86 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">RPM término >24 h</h2>
|
| 87 |
+
<div class="treatment-option"><div class="treatment-title">Profilaxis</div><p>Ampicilina 2 g IV + Ampicilina 1 g/4 h IV hasta parto.</p></div>
|
| 88 |
+
<div class="treatment-option"><div class="treatment-title">Alergia</div><p>Clindamicina 900 mg/8 h IV o Vancomicina 1 g/12 h IV.</p></div>
|
| 89 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Inducción inmediata.</li></ul></div>
|
| 90 |
+
</div>
|
| 91 |
+
<!-- RPM tardío 34+0–36+6 -->
|
| 92 |
+
<div id="rpm_tardio" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 93 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">RPM pretérmino tardío (34+0–36+6)</h2>
|
| 94 |
+
<div class="treatment-option"><div class="treatment-title">Profilaxis</div><p>Ampicilina 2 g IV + Ampicilina 1 g/4 h IV ×48 h.</p></div>
|
| 95 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Si trabajo de parto tras 48 h, iniciar cobertura SGB.</li></ul></div>
|
| 96 |
+
</div>
|
| 97 |
+
<!-- RPM pretérmino 24+0–33+6 -->
|
| 98 |
+
<div id="rpm_preterm" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 99 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">RPM pretérmino (24+0–33+6)</h2>
|
| 100 |
+
<div class="treatment-option"><div class="treatment-title">Tratamiento latencia</div><p>Azitromicina 1 g VO + Ampicilina 2 g/6 h IV ×48 h, luego Amoxicilina 500 mg/8 h VO ×5 d.</p></div>
|
| 101 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Si parto tras 7 días, iniciar profilaxis SGB.</li></ul></div>
|
| 102 |
+
</div>
|
| 103 |
+
<!-- RPM previabilidad <24+0 -->
|
| 104 |
+
<div id="rpm_previabilidad" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 105 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">RPM previabilidad (<24+0)</h2>
|
| 106 |
+
<div class="treatment-option"><div class="treatment-title">Tratamiento latencia</div><p>Amoxicilina 500 mg/8 h VO ×5 d + Azitromicina 1 g VO dosis única.</p></div>
|
| 107 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Azitromicina 1 g VO + Clindamicina 300 mg/8 h VO ×5 d.</p></div>
|
| 108 |
+
</div>
|
| 109 |
+
<!-- Amenaza parto prematuro -->
|
| 110 |
+
<div id="app" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 111 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Amenaza parto prematuro</h2>
|
| 112 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ampicilina 2 g/6 h IV + Ceftriaxona 1 g/12 h IV + Claritromicina 500 mg/12 h VO.</p></div>
|
| 113 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Solo si infección intraamniótica.</li></ul></div>
|
| 114 |
+
</div>
|
| 115 |
+
<!-- Corioamnionitis -->
|
| 116 |
+
<div id="corioamnionitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 117 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Corioamnionitis</h2>
|
| 118 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Piperacilina/Tazobactam 4 g/6 h IV + Claritromicina 500 mg/12 h VO.</p></div>
|
| 119 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Finalizar gestación bajo cobertura, mantener 48 h afebril.</li></ul></div>
|
| 120 |
+
</div>
|
| 121 |
+
<!-- Fiebre intraparto -->
|
| 122 |
+
<div id="fiebre_intraparto" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 123 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Fiebre intraparto</h2>
|
| 124 |
+
<div class="treatment-option"><div class="treatment-title">De elección sin BLEE</div><p><37 sem: Piperacilina/Tazobactam 4 g/6 h IV + Claritromicina 500 mg/12 h VO; ��37 sem: Piperacilina/Tazobactam 4 g/6 h IV.</p></div>
|
| 125 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Teicoplanina + Aztreonam + Metronidazol o Tigeciclina + Metronidazol.</p></div>
|
| 126 |
+
</div>
|
| 127 |
+
<!-- Presencia SGB -->
|
| 128 |
+
<div id="sgb" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 129 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Positividad SGB</h2>
|
| 130 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Penicilina G 5 MUI carga → 2.5 MUI/4 h IV hasta parto.</p></div>
|
| 131 |
+
<div class="note-box"><div class="note-title">Alternativa / Alergia</div><ul><li>Ampicilina 2 g → 1 g/4 h IV.</li><li>Clindamicina 900 mg/8 h o Vancomicina 1 g/12 h.</li></ul></div>
|
| 132 |
+
</div>
|
| 133 |
+
<!-- Cesárea -->
|
| 134 |
+
<div id="cesarea" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 135 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Profilaxis en cesárea</h2>
|
| 136 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Cefazolina 2 g IV dosis única (60 min antes).</p></div>
|
| 137 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Clindamicina 1200 mg + Gentamicina 240 mg dosis única.</p></div>
|
| 138 |
+
</div>
|
| 139 |
+
<!-- Alumbramiento manual/lavado -->
|
| 140 |
+
<div id="alumbramiento_manual" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 141 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Alumbramiento/Revisión manual</h2>
|
| 142 |
+
<div class="treatment-option"><div class="treatment-title">Profilaxis</div><p>Cefazolina 2 g IV dosis única.</p></div>
|
| 143 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Clindamicina 1200 mg IV dosis única.</p></div>
|
| 144 |
+
</div>
|
| 145 |
+
<!-- Lesión esfínter anal -->
|
| 146 |
+
<div id="lesion_esfinter" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 147 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Lesión esfínter anal 3º/4º grado</h2>
|
| 148 |
+
<div class="treatment-option"><div class="treatment-title">3A</div><p>Cefotaxima 2 g IV dosis única.</p></div>
|
| 149 |
+
<div class="treatment-option"><div class="treatment-title">3B/3C</div><p>Cefotaxima 2 g IV + Cefuroxima 250 mg/12 h VO + Metronidazol 250 mg/8 h VO ×5 d.</p></div>
|
| 150 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Gentamicina + Metronidazol IV/VO.</p></div>
|
| 151 |
+
</div>
|
| 152 |
+
<!-- Legrado obstétrico y cerclaje (no ATB) -->
|
| 153 |
+
<div id="legrado" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200"><h2 class="text-2xl font-bold text-gray-800 mb-4">Legrado obstétrico / Cerclaje</h2><div class="note-box"><div class="note-title">Observaciones</div><ul><li>No precisa tratamiento ni profilaxis.</li></ul></div></div>
|
| 154 |
+
<!-- Mastitis -->
|
| 155 |
+
<div id="mastitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 156 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Mastitis puerperal</h2>
|
| 157 |
+
<div class="treatment-option"><div class="treatment-title">Leve</div><p>Cefalexina 500 mg/6 h VO o Cefadroxilo 1 g/12 h VO.</p></div>
|
| 158 |
+
<div class="treatment-option"><div class="treatment-title">Grave</div><p>Cefazolina 2 g/8 h IV + Vancomicina 1 g/12 h IV.</p></div>
|
| 159 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>No interrumpir lactancia; duración 7-10 días.</li></ul></div>
|
| 160 |
+
</div>
|
| 161 |
+
<!-- Infección herida quirúrgica puerperal -->
|
| 162 |
+
<div id="herida_quirurgica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 163 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Infección de herida quirúrgica</h2>
|
| 164 |
+
<div class="treatment-option"><div class="treatment-title">Superficial</div><p>Amoxi/clav 875/125 mg/8 h VO ×5 d.</p></div>
|
| 165 |
+
<div class="treatment-option"><div class="treatment-title">Profunda</div><p>Ceftriaxona 2 g/24 h IV + Metronidazol 500 mg/8 h IV.</p></div>
|
| 166 |
+
<div class="note-box"><div class="note-title">Manejo</div><ul><li>Desbridamiento, muestras a Microbiología.</li></ul></div>
|
| 167 |
+
</div>
|
| 168 |
+
<!-- Endometritis puerperal -->
|
| 169 |
+
<div id="endometritis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 170 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Endometritis puerperal</h2>
|
| 171 |
+
<div class="treatment-option"><div class="treatment-title">Leve</div><p>Cefixima 400 mg/24 h VO + Metronidazol 500 mg/8 h VO ×5 d.</p></div>
|
| 172 |
+
<div class="treatment-option"><div class="treatment-title">Grave</div><p>Ceftriaxona 2 g/24 h IV + Metronidazol 500 mg/8 h IV ± Azitromicina 1 g dosis única.</p></div>
|
| 173 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Mantener 48 h afebril.</li></ul></div>
|
| 174 |
+
</div>
|
| 175 |
+
<!-- Abscesos intraabdominales -->
|
| 176 |
+
<div id="abscesos" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 177 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Abscesos intraabdominales</h2>
|
| 178 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Amoxi/clav 1 g/6 h IV ×7 d o Ceftriaxona 2 g/24 h IV + Metronidazol 500 mg/8 h IV ×7 d.</p></div>
|
| 179 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Drenaje percutáneo o cirugía.</li></ul></div>
|
| 180 |
+
</div>
|
| 181 |
+
<!-- Bacteriuria asintomática -->
|
| 182 |
+
<div id="bacteriuria_asint" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 183 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Bacteriuria asintomática</h2>
|
| 184 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Fosfomicina trometamol 3 g VO dosis única.</p></div>
|
| 185 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Urocultivo de control 7-15 d después y trimestral.</li></ul></div>
|
| 186 |
+
</div>
|
| 187 |
+
<!-- Cistitis -->
|
| 188 |
+
<div id="cistitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 189 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Cistitis</h2>
|
| 190 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Fosfomicina trometamol 3 g VO dosis única.</p></div>
|
| 191 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Cefuroxima 500 mg/12 h VO ×5 d.</p></div>
|
| 192 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Nitrofurantoína 100 mg/8 h VO ×5 d.</p></div>
|
| 193 |
+
</div>
|
| 194 |
+
<!-- Pielonefritis -->
|
| 195 |
+
<div id="pielonefritis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 196 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Pielonefritis</h2>
|
| 197 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ceftriaxona 2 g/24 h IV hasta 24-48 h afebril → Cefuroxima 500 mg/12 h VO.</p></div>
|
| 198 |
+
<div class="note-box"><div class="note-title">Alergia</div><p>Aztreonam 1 g/8 h IV.</p></div>
|
| 199 |
+
</div>
|
| 200 |
+
<!-- Faringoamigdalitis -->
|
| 201 |
+
<div id="faringoamigdalitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 202 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Faringoamigdalitis</h2>
|
| 203 |
+
<div class="note-box"><div class="note-title">Manejo inicial</div><p>Tratamiento sintomático; si criterios Centor ≥3 y test +: Penicilina V o Amoxicilina.</p></div>
|
| 204 |
+
</div>
|
| 205 |
+
<!-- Bronquitis -->
|
| 206 |
+
<div id="bronquitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 207 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Bronquitis</h2>
|
| 208 |
+
<div class="note-box"><div class="note-title">Manejo inicial</div><p>Tratamiento sintomático; si no mejora: Amoxicilina o Azitromicina.</p></div>
|
| 209 |
+
</div>
|
| 210 |
+
<!-- Gripe -->
|
| 211 |
+
<div id="gripe" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 212 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Gripe</h2>
|
| 213 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Oseltamivir 75 mg/12 h VO ×5 d.</p></div>
|
| 214 |
+
</div>
|
| 215 |
+
<!-- Neumonía -->
|
| 216 |
+
<div id="neumonia" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 217 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Neumonía comunitaria</h2>
|
| 218 |
+
<div class="treatment-option"><div class="treatment-title">Ambulatoria</div><p>Amoxicilina 1 g/8 h VO ± Azitromicina.</p></div>
|
| 219 |
+
<div class="treatment-option"><div class="treatment-title">Ingreso</div><p>Ceftriaxona 2 g/24 h IV ± Azitromicina.</p></div>
|
| 220 |
+
</div>
|
| 221 |
+
<!-- Otitis externa -->
|
| 222 |
+
<div id="otitis_externa" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 223 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Otitis externa</h2>
|
| 224 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ciprofloxacino o Tobramicina gotas, 7 d.</p></div>
|
| 225 |
+
</div>
|
| 226 |
+
<!-- Otitis media -->
|
| 227 |
+
<div id="otitis_media" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border_GRAY-200">
|
| 228 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Otitis media</h2>
|
| 229 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Amoxicilina 750 mg/8 h VO ×5-7 d.</p></div>
|
| 230 |
+
</div>
|
| 231 |
+
<!-- Sinusitis -->
|
| 232 |
+
<div id="sinusitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 233 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Sinusitis</h2>
|
| 234 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Amoxicilina 500 mg/8 h VO ×5-7 d.</p></div>
|
| 235 |
+
</div>
|
| 236 |
+
<!-- Infección odontógena -->
|
| 237 |
+
<div id="odontogena" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 238 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Infección odontógena</h2>
|
| 239 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Amoxicilina 500-750 mg/8 h VO ×8-10 d.</p></div>
|
| 240 |
+
</div>
|
| 241 |
+
<!-- Piel impétigo/foliculitis -->
|
| 242 |
+
<div id="inf_locales" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 243 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Impétigo/Foliculitis</h2>
|
| 244 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Fusídico tópico ×5 d o Mupirocina tópico ×5 d.</p></div>
|
| 245 |
+
</div>
|
| 246 |
+
<!-- Celulitis/erisipela -->
|
| 247 |
+
<div id="inf_moderadas" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 248 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Celulitis/Erisipela</h2>
|
| 249 |
+
<div class="treatment-option"><div class="treatment-title">Leve</div><p>Amoxicilina 500 mg/8 h VO.</p></div>
|
| 250 |
+
<div class="treatment-option"><div class="treatment-title">Moderada</div><p>Cefazolina 1 g/8 h IV.</p></div>
|
| 251 |
+
</div>
|
| 252 |
+
<!-- Fascitis necrotizante -->
|
| 253 |
+
<div id="inf_necrotizante" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border_GRAY-200">
|
| 254 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Fascitis necrotizante</h2>
|
| 255 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Penicilina G 4 MU/4 h IV + Clindamicina 600-900 mg/8 h IV.</p></div>
|
| 256 |
+
</div>
|
| 257 |
+
<!-- Gastroenteritis -->
|
| 258 |
+
<div id="gastroenteritis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 259 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Gastroenteritis</h2>
|
| 260 |
+
<div class="note-box"><div class="note-title">Manejo</div><p>Tratamiento sintomático; si gravedad: Ceftriaxona 1 g/24 h IV ×3-5 d.</p></div>
|
| 261 |
+
</div>
|
| 262 |
+
<!-- Colecistitis/colangitis -->
|
| 263 |
+
<div id="colecistitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 264 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Colecistitis/colangitis</h2>
|
| 265 |
+
<div class="treatment-option"><div class="treatment-title">IQ</div><p>Ceftriaxona 1 g/24 h IV ×3 d tras cirugía.</p></div>
|
| 266 |
+
<div class="treatment-option"><div class="treatment-title">No IQ</div><p>Ceftriaxona 1 g/24 h IV ×7-10 d.</p></div>
|
| 267 |
+
</div>
|
| 268 |
+
<!-- Diverticulitis/absceso -->
|
| 269 |
+
<div id="diverticulitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 270 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Diverticulitis/absceso</h2>
|
| 271 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Amoxi/clav 1 g/8 h IV o Ceftriaxona + Metronidazol IV.</p></div>
|
| 272 |
+
</div>
|
| 273 |
+
</div>
|
| 274 |
+
<script>
|
| 275 |
+
const sel=document.getElementById('sel'),res=document.getElementById('result'),store=document.getElementById('store');
|
| 276 |
+
sel.addEventListener('change',()=>{res.innerHTML='';const id=sel.value;if(!id)return;const node=store.querySelector('#'+id);if(node)res.appendChild(node.cloneNode(true));});
|
| 277 |
+
</script>
|
| 278 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 279 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 280 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 281 |
+
</div>
|
| 282 |
+
</div>
|
| 283 |
+
</body>
|
| 284 |
+
</html>
|
proa/endocarditis_infecciosa.html
ADDED
|
@@ -0,0 +1,109 @@
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|
|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Endocarditis</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1),0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 15 |
+
.treatment-option { background: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; }
|
| 16 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 17 |
+
.note-box { background: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 18 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 19 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 20 |
+
li { margin-bottom: 0.25rem; }
|
| 21 |
+
</style>
|
| 22 |
+
</head>
|
| 23 |
+
<body class="min-h-screen bg-gray-50">
|
| 24 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 25 |
+
<div class="flex items-center gap-3 mb-6">
|
| 26 |
+
<div class="bg-red-600 p-2 rounded-lg text-white"><i class="fas fa-heart text-2xl"></i></div>
|
| 27 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Endocarditis Infecciosa</h1>
|
| 28 |
+
</div>
|
| 29 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 30 |
+
<label for="sel" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Selecciona categoría</label>
|
| 31 |
+
<select id="sel" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-red-500 focus:border-red-500">
|
| 32 |
+
<option value="">-- Elige categoría --</option>
|
| 33 |
+
<option value="nativa_aguda">Válvula nativa: Aguda</option>
|
| 34 |
+
<option value="nativa_subaguda">Válvula nativa: Subaguda</option>
|
| 35 |
+
<option value="protesica_precoz">Válvula protésica: Precoz</option>
|
| 36 |
+
<option value="protesica_tardia">Válvula protésica: Tardía</option>
|
| 37 |
+
<option value="disp_superficial">Dispositivo: Infección superficial</option>
|
| 38 |
+
<option value="disp_no_complicada">Dispositivo: No complicada</option>
|
| 39 |
+
<option value="disp_complicada">Dispositivo: Complicada</option>
|
| 40 |
+
</select>
|
| 41 |
+
</div>
|
| 42 |
+
<div id="result" class="space-y-6"></div>
|
| 43 |
+
<div id="store" class="hidden">
|
| 44 |
+
<!-- Válvula nativa: Aguda -->
|
| 45 |
+
<div id="nativa_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 46 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Válvula nativa: Aguda</h2>
|
| 47 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Streptococos viridans</span></div>
|
| 48 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ampicilina 2 g c/4 h + Cefazolina 2 g c/8 h ± Gentamicina 3 mg/kg/d c/24 h.</p></div>
|
| 49 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Daptomicina 10 mg/kg/d + Fosfomicina 4 g c/6 h o Gentamicina 3 mg/kg/d c/24 h.</p></div>
|
| 50 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Empírico solo si IC, inestabilidad o embolia.</li><li>Hemocultivos seriados cada 48-72 h hasta negativizar.</li><li>Duración según germen y cirugía: 2–4 sem para viridans, ≥4 sem para aureus.</li></ul></div>
|
| 51 |
+
</div>
|
| 52 |
+
<!-- Válvula nativa: Subaguda -->
|
| 53 |
+
<div id="nativa_subaguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 54 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Válvula nativa: Subaguda</h2>
|
| 55 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Streptococos viridans</span></div>
|
| 56 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ampicilina 2 g c/4 h + Ceftriaxona 2 g c/12 h.</p></div>
|
| 57 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Daptomicina 10 mg/kg/d.</p></div>
|
| 58 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Igual HaD tras fase inicial estable.</li><li>Duración ≥4 semanas.</li></ul></div>
|
| 59 |
+
</div>
|
| 60 |
+
<!-- Válvula protésica: Precoz -->
|
| 61 |
+
<div id="protesica_precoz" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 62 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Válvula protésica: Precoz</h2>
|
| 63 |
+
<div class="pathogen-list"><span class="pathogen-item">Coagulasa-negativos</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">E. faecalis</span></div>
|
| 64 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Daptomicina 10 mg/kg/d + Meropenem 2 g c/8 h o Piperacilina/Tazobactam 4,5 g c/6 h.</p></div>
|
| 65 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Daptomicina + Gentamicina 3 mg/kg/d (añadir Rifampicina 300 mg v.o c/8 h tras 3-5 d).</p></div>
|
| 66 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Empírico solo si IC, embolia o inestabilidad.</li><li>Duración 6–8 semanas desde hemocultivo negativo.</li></ul></div>
|
| 67 |
+
</div>
|
| 68 |
+
<!-- Válvula protésica: Tardía -->
|
| 69 |
+
<div id="protesica_tardia" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 70 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Válvula protésica: Tardía</h2>
|
| 71 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Viridans</span></div>
|
| 72 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Cloxacilina 2 g c/4 h + Ampicilina 2 g c/4 h + Ceftriaxona 2 g c/12 h.</p></div>
|
| 73 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ampicilina 2 g c/4 h + Ceftarolina 600 mg c/8 h (± Daptomicina si sepsis).</p></div>
|
| 74 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Duración 6 semanas desde cultivo negativo.</li><li>HaD tras fase inical estable.</li></ul></div>
|
| 75 |
+
</div>
|
| 76 |
+
<!-- Dispositivo superficial -->
|
| 77 |
+
<div id="disp_superficial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 78 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Dispositivo intracardíaco: Superficial</h2>
|
| 79 |
+
<div class="pathogen-list"><span class="pathogen-item">Coagulasa-negativos</span><span class="pathogen-item">S. aureus</span></div>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Amoxi/clav 875/125 mg c/8 h VO o Cotrimoxazol 320/800 mg c/12 h VO.</p></div>
|
| 81 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Linezolid 600 mg c/12 h VO o Clindamicina 600 mg c/8 h VO.</p></div>
|
| 82 |
+
<div class="note-box"><div class="note-title">Duración</div><ul><li>7–10 días.</li></ul></div>
|
| 83 |
+
</div>
|
| 84 |
+
<!-- Dispositivo no complicada -->
|
| 85 |
+
<div id="disp_no_complicada" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 86 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Dispositivo intracardíaco: No complicada</h2>
|
| 87 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Linezolid 600 mg c/12 h VO/IV o Daptomicina 8–10 mg/kg/d + Ceftriaxona 1 g c/12 h IV.</p></div>
|
| 88 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Linezolid + Gentamicina 3 mg/kg/d IV.</p></div>
|
| 89 |
+
<div class="note-box"><div class="note-title">Duración</div><ul><li>Hasta 10 días tras extracción y ≥48 h tras nuevo implante.</li></ul></div>
|
| 90 |
+
</div>
|
| 91 |
+
<!-- Dispositivo complicada -->
|
| 92 |
+
<div id="disp_complicada" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 93 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Dispositivo intracardíaco: Complicada</h2>
|
| 94 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Daptomicina 10 mg/kg/d + Meropenem 2 g c/8 h o Piperacilina/Tazobactam 4,5 g c/6 h IV.</p></div>
|
| 95 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Daptomicina + Gentamicina 3 mg/kg/d + Rifampicina 900–1200 mg VO.</p></div>
|
| 96 |
+
<div class="note-box"><div class="note-title">Duración</div><ul><li>2 semanas tras extracción completa; ≥4 semanas si bacteriemia persistente; ≥6 semanas si endocarditis concomitante.</li></ul></div>
|
| 97 |
+
</div>
|
| 98 |
+
</div>
|
| 99 |
+
<script>
|
| 100 |
+
const sel = document.getElementById('sel'), res = document.getElementById('result'), store = document.getElementById('store');
|
| 101 |
+
sel.addEventListener('change', () => { res.innerHTML = ''; const id = sel.value; if (!id) return; const node = store.querySelector('#' + id); if (node) res.appendChild(node.cloneNode(true)); });
|
| 102 |
+
</script>
|
| 103 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 104 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 105 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 106 |
+
</div>
|
| 107 |
+
</div>
|
| 108 |
+
</body>
|
| 109 |
+
</html>
|
proa/ginecologia.html
ADDED
|
@@ -0,0 +1,140 @@
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|
|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Ginecológicas</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all .3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1),0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right .5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 15 |
+
.treatment-option { background:white; border-left:4px solid #8b5cf6; border-radius:.5rem; padding:1rem; margin:1rem 0 .5rem; }
|
| 16 |
+
.treatment-title { font-weight:600; color:#5b21b6; margin-bottom:.5rem; display:flex; align-items:center; gap:.5rem; }
|
| 17 |
+
.note-box { background:#f3e8ff; border-left:4px solid #a78bfa; padding:.75rem; margin:1rem 0; border-radius:0 .5rem .5rem 0; }
|
| 18 |
+
.note-title { font-weight:600; color:#5b21b6; display:flex; align-items:center; gap:.5rem; margin-bottom:.5rem; }
|
| 19 |
+
ul { margin-left:1.25rem; } li { margin-bottom:.25rem; }
|
| 20 |
+
optgroup { font-style:italic; }
|
| 21 |
+
</style>
|
| 22 |
+
</head>
|
| 23 |
+
<body class="min-h-screen bg-gray-50">
|
| 24 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 25 |
+
<div class="flex items-center gap-3 mb-6">
|
| 26 |
+
<div class="bg-purple-600 p-2 rounded-lg text-white"><i class="fas fa-female text-2xl"></i></div>
|
| 27 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Ginecológicas</h1>
|
| 28 |
+
</div>
|
| 29 |
+
<div class="bg-white rounded-xl shadow p-6 mb-6">
|
| 30 |
+
<label for="sel" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-layer-group text-purple-500"></i> Seleccione categoría</label>
|
| 31 |
+
<select id="sel" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-purple-500 focus:border-purple-500">
|
| 32 |
+
<option value="">-- Elige categoría --</option>
|
| 33 |
+
<optgroup label="Cervicitis">
|
| 34 |
+
<option value="cerv_sin">Sin etiología conocida</option>
|
| 35 |
+
<option value="cerv_gono">N. gonorrhoeae</option>
|
| 36 |
+
<option value="cerv_chlam">C. trachomatis</option>
|
| 37 |
+
</optgroup>
|
| 38 |
+
<optgroup label="Vulvovaginitis">
|
| 39 |
+
<option value="vulvo_candi">Candidiasis</option>
|
| 40 |
+
<option value="vulvo_vagino">Vaginosis bacteriana</option>
|
| 41 |
+
</optgroup>
|
| 42 |
+
<optgroup label="Úlceras genitales">
|
| 43 |
+
<option value="ulc_sif_pri">Sífilis <1 año</option>
|
| 44 |
+
<option value="ulc_sif_lat">Sífilis >1 año</option>
|
| 45 |
+
<option value="ulc_neuro">Neurosífilis</option>
|
| 46 |
+
</optgroup>
|
| 47 |
+
<option value="epi">Enfermedad Inflamatoria Pélvica</option>
|
| 48 |
+
<option value="verru">Verrugas genitales</option>
|
| 49 |
+
<option value="endo_sec">Endometritis secundaria</option>
|
| 50 |
+
</select>
|
| 51 |
+
</div>
|
| 52 |
+
<div id="result" class="space-y-6"></div>
|
| 53 |
+
<div id="store" class="hidden">
|
| 54 |
+
<!-- Cervicitis sin etiología conocida -->
|
| 55 |
+
<div id="cerv_sin" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 56 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Cervicitis (sin etiología conocida)</h2>
|
| 57 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ceftriaxona 500 mg IM + Azitromicina 1 g VO o Doxiciclina 100 mg/12 h VO ×7 d.</p></div>
|
| 58 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Cefixima 400 mg VO + Azitromicina 2 g VO o Doxiciclina 100 mg/12 h VO ×7 d.</p></div>
|
| 59 |
+
<div class="treatment-option"><div class="treatment-title">Alergia</div><p>Azitromicina 2 g VO + Doxiciclina 100 mg/12 h VO ×7 d.</p></div>
|
| 60 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Alta sospecha gonococo: Azitromicina preferente.</li></ul></div>
|
| 61 |
+
</div>
|
| 62 |
+
<!-- Cervicitis gonocócica -->
|
| 63 |
+
<div id="cerv_gono" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 64 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Cervicitis por N. gonorrhoeae</h2>
|
| 65 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Ceftriaxona 500 mg IM + Azitromicina 1 g VO.</p></div>
|
| 66 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Cefixima 400 mg VO + Azitromicina 2 g VO.</p></div>
|
| 67 |
+
<div class="treatment-option"><div class="treatment-title">Alergia</div><p>Azitromicina 2 g VO + Gentamicina 240 mg IV o Ciprofloxacino 500 mg VO.</p></div>
|
| 68 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Gonorrea puede diseminarse (conjuntivitis, artropatía).</li><li>Resistencia a quinolonas ≥50%.</li></ul></div>
|
| 69 |
+
</div>
|
| 70 |
+
<!-- Cervicitis por Chlamydia -->
|
| 71 |
+
<div id="cerv_chlam" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 72 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Cervicitis por C. trachomatis</h2>
|
| 73 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Azitromicina 1 g VO dosis única o Doxiciclina 100 mg/12 h VO ×7 d.</p></div>
|
| 74 |
+
<div class="note-box"><div class="note-title">Linfogranuloma venéreo</div><p>Doxiciclina 100 mg/12 h VO ×21 d o Azitromicina 1 g VO semanal ×3 semanas.</p></div>
|
| 75 |
+
</div>
|
| 76 |
+
<!-- Vulvovaginitis candidiasis -->
|
| 77 |
+
<div id="vulvo_candi" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 78 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Candidiasis Vulvovaginal</h2>
|
| 79 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Clotrimazol 500 mg óvulo único o 200 mg/24 h ×3 d; crema 1% ×7-14 d.</p></div>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Fluconazol 15 mg VO dosis única.</p></div>
|
| 81 |
+
<div class="note-box"><div class="note-title">Recurrente / Embarazo</div><ul><li>Recurrente: Fluconazol 150 mg ×3, luego 150 mg semanal ×6 m.</li><li>Embarazadas: Clotrimazol 100 mg ×7 d.</li></ul></div>
|
| 82 |
+
</div>
|
| 83 |
+
<!-- Vulvovaginitis vaginosis -->
|
| 84 |
+
<div id="vulvo_vagino" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 85 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Vaginosis Bacteriana</h2>
|
| 86 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Metronidazol 500 mg VO/12 h ×7 d o gel 0.75% 5 g/24 h ×5 d.</p></div>
|
| 87 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Clindamicina crema 2% 5 g/24 h ×7 d.</p></div>
|
| 88 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>No ITS, asociado mayor riesgo de ITS.</li></ul></div>
|
| 89 |
+
</div>
|
| 90 |
+
<!-- Úlceras genitales sífilis primaria -->
|
| 91 |
+
<div id="ulc_sif_pri" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 92 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Sífilis primaria/latente precoz</h2>
|
| 93 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Penicilina G benzatina 2.4 MUI IM dosis única.</p></div>
|
| 94 |
+
<div class="treatment-option"><div class="treatment-title">Alergia</div><p>Azitromicina 2 g VO o Doxiciclina 100 mg/12 h ×14 d.</p></div>
|
| 95 |
+
<div class="note-box"><div class="note-title">Embarazo</div><p>Eritromicina 500 mg/6 h ×14 d + Azitromicina 2 g.</p></div>
|
| 96 |
+
</div>
|
| 97 |
+
<!-- Úlceras sífilis latente tardía -->
|
| 98 |
+
<div id="ulc_sif_lat" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 99 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Sífilis latente tardía</h2>
|
| 100 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Penicilina G benzatina 2.4 MUI IM semanales ×3 semanas.</p></div>
|
| 101 |
+
<div class="treatment-option"><div class="treatment-title">Alergia</div><p>Doxiciclina 100 mg/12 h VO ×28 d.</p></div>
|
| 102 |
+
</div>
|
| 103 |
+
<!-- Neurosífilis -->
|
| 104 |
+
<div id="ulc_neuro" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 105 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Neurosífilis</h2>
|
| 106 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Penicilina G IV 3-4 MUI/4 h o 18-24 MUI infusión continua ×14 d.</p></div>
|
| 107 |
+
<div class="treatment-option"><div class="treatment-title">Alternativa</div><p>Ceftriaxona 2 g/24 h IV ×14 d.</p></div>
|
| 108 |
+
</div>
|
| 109 |
+
<!-- EPI -->
|
| 110 |
+
<div id="epi" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 111 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Enfermedad Inflamatoria Pélvica (EPI)</h2>
|
| 112 |
+
<div class="treatment-option"><div class="treatment-title">Ambulatorio</div><p>Ceftriaxona 0.5-1 g IM + Doxiciclina 100 mg/12 h VO ×14 d ± Metronidazol 500 mg/12 h ×14 d.</p></div>
|
| 113 |
+
<div class="treatment-option"><div class="treatment-title">Hospitalización</div><p>Doxiciclina 100 mg/12 h + Ceftriaxona 2 g + Metronidazol 500 mg/8 h IV ×14 d.</p></div>
|
| 114 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Hospitalizar en embarazo, absceso o mala respuesta.</li></ul></div>
|
| 115 |
+
</div>
|
| 116 |
+
<!-- Verrugas genitales -->
|
| 117 |
+
<div id="verru" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 118 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Verrugas Genitales</h2>
|
| 119 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Podofilotoxina 2 aplicaciones/d ×3 d/semana, Sinacatequinas 3 aplic/d ×16 sem, Imiquimod o 5-FU tópico.</p></div>
|
| 120 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>No requiere estudio etiológico; derivar a dermato (crioterapia).</li></ul></div>
|
| 121 |
+
</div>
|
| 122 |
+
<!-- Endometritis secundaria -->
|
| 123 |
+
<div id="endo_sec" class="treatment-card bg-white rounded-lg shadow p-6 border border-gray-200">
|
| 124 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4">Endometritis Secundaria</h2>
|
| 125 |
+
<div class="treatment-option"><div class="treatment-title">De elección</div><p>Clindamicina 900 mg IV + Gentamicina 5 mg/kg/24 h IV hasta 48 h afebril.</p></div>
|
| 126 |
+
<div class="treatment-option"><div class="treatment-title">Alternativas</div><p>Amoxi/clav 6-8 h o Piperacilina/Tazobactam 4 g/6 h; Ceftriaxona 1 g/24 h + Metronidazol 500 mg/8 h.</p></div>
|
| 127 |
+
<div class="note-box"><div class="note-title">Observaciones</div><ul><li>Clinda preferible en lactancia.</li><li>Completar 7 d VO si bacteriemia.</li></ul></div>
|
| 128 |
+
</div>
|
| 129 |
+
</div>
|
| 130 |
+
<script>
|
| 131 |
+
const sel=document.getElementById('sel'), res=document.getElementById('result'), store=document.getElementById('store');
|
| 132 |
+
sel.addEventListener('change', ()=>{ res.innerHTML=''; const id=sel.value; if(!id) return; const node=store.querySelector('#'+id); if(node) res.appendChild(node.cloneNode(true)); });
|
| 133 |
+
</script>
|
| 134 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 135 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 136 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 137 |
+
</div>
|
| 138 |
+
</div>
|
| 139 |
+
</body>
|
| 140 |
+
</html>
|
proa/infecciones_tracto_urinario_adultos.html
ADDED
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Tracto Urinario (Adultos)</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
.sub-category { border-top: 1px dashed #cbd5e1; margin-top: 1.5rem; padding-top: 1.5rem; }
|
| 24 |
+
.sub-category-title { font-size: 1.25rem; font-weight: 600; color: #4b5563; margin-bottom: 1rem; }
|
| 25 |
+
</style>
|
| 26 |
+
</head>
|
| 27 |
+
<body class="min-h-screen bg-gray-50">
|
| 28 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 29 |
+
<div class="flex items-center gap-3 mb-6">
|
| 30 |
+
<div class="bg-cyan-600 p-2 rounded-lg text-white"><i class="fas fa-bacteria text-2xl"></i></div>
|
| 31 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Tracto Urinario (Adultos)</h1>
|
| 32 |
+
</div>
|
| 33 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 34 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-cyan-500"></i> Tipo de Infección Urinaria</label>
|
| 35 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 36 |
+
<option value="">-- Selecciona un tipo --</option>
|
| 37 |
+
<option value="bacteriuria_asintomatica">Bacteriuria Asintomática</option>
|
| 38 |
+
<option value="cistitis_aguda">Cistitis Aguda</option>
|
| 39 |
+
<option value="pielonefritis_aguda">Pielonefritis Aguda</option>
|
| 40 |
+
<option value="prostatitis_aguda">Prostatitis Aguda</option>
|
| 41 |
+
<option value="orquiepididimitis">Orquiepididimitis</option>
|
| 42 |
+
<option value="paciente_sondado">Infección en Paciente Sondado</option>
|
| 43 |
+
</select>
|
| 44 |
+
</div>
|
| 45 |
+
<div id="result" class="space-y-6"></div>
|
| 46 |
+
|
| 47 |
+
<div id="guide-content-storage" class="hidden">
|
| 48 |
+
|
| 49 |
+
<div id="bacteriuria_asintomatica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 50 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-ban text-gray-500"></i> Bacteriuria Asintomática</h2>
|
| 51 |
+
<p class="text-sm text-gray-600 mb-4">Definición: Mujeres ($\ge 10^5$ UFC/mL en 2 urocultivos), Varones ($\ge 10^5$ UFC/mL en 1 urocultivo).</p>
|
| 52 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">E. coli (más frecuente)</span><span class="pathogen-item">Otros microorganismos</span><span class="pathogen-item">Candida spp.</span></div></div>
|
| 53 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-red-500"></i> Tratamiento</h3>
|
| 54 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-times-circle text-red-600"></i> Generalmente NO INDICADO</div><p class="text-gray-700">El tratamiento antibiótico no está indicado de forma rutinaria.</p></div>
|
| 55 |
+
<div class="treatment-option border-yellow-500"><div class="treatment-title"><i class="fas fa-exclamation-triangle text-yellow-600"></i> Excepciones (Tratar si):</div><ul class="list-disc text-gray-700 space-y-1 ml-5"><li>Embarazo.</li><li>Previo a procedimiento urológico con riesgo de sangrado.</li><li>Candiduria con riesgo de enfermedad diseminada (Neutropenia, inmunodepresión, procedimientos urológicos invasivos).</li></ul></div>
|
| 56 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Tratamiento (si indicado por excepción)</div><p class="text-gray-700 mb-1"><strong>Bacteriana:</strong></p><ul class="list-disc text-gray-700 space-y-1 ml-5"><li><strong>De elección (si sensible):</strong> Fosfomicina trometamol 3 g VO dosis única (toma nocturna).</li><li><strong>Alternativa:</strong> Cefuroxima 250 mg/12h VO, 5 días.</li><li><strong>Alergia Beta-lactámicos:</strong> Nitrofurantoína 100 mg/8h VO, 5 días.</li></ul><p class="text-gray-700 mt-2 mb-1"><strong>Candiduria (con riesgo diseminación):</strong></p><ul class="list-disc text-gray-700 space-y-1 ml-5"><li>Fluconazol 200 mg/día VO (400 mg si neutropenia) durante 2 semanas.</li></ul></div>
|
| 57 |
+
</div>
|
| 58 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones</div><ul class="list-disc text-gray-700 space-y-1"><li>La presencia de piuria aislada NO es criterio para tratamiento.</li><li>NO realizar urocultivo de rutina sin clínica en sondados, ancianos, diabéticos, etc.</li><li>Recambios de sonda vesical NO requieren profilaxis antibiótica.</li><li>En Candiduria: Retirar o recambiar sonda si es posible.</li><li><strong>Nitrofurantoína:</strong> NO usar si ClCr $< 50$ ml/min, ni en tto > 7 días o profilaxis. Evitar en 1er trimestre embarazo y a término si hay alternativas.</li><li>Si tto pre-procedimiento urológico y se mantiene sonda: continuar tto hasta retirada (máx 7 días post-intervención).</li></ul></div>
|
| 59 |
+
</div>
|
| 60 |
+
|
| 61 |
+
<div id="cistitis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 62 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-fire text-orange-500"></i> Cistitis Aguda</h2>
|
| 63 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">E. coli (>80%)</span><span class="pathogen-item">Otras enterobacterias</span><span class="pathogen-item">E. faecalis</span><span class="pathogen-item">Proteus spp.</span><span class="pathogen-item">S. saprophyticus</span></div></div>
|
| 64 |
+
|
| 65 |
+
<div class="sub-category">
|
| 66 |
+
<h3 class="sub-category-title"><i class="fas fa-female text-pink-500 mr-2"></i>Cistitis Simple (No complicada)</h3>
|
| 67 |
+
<p class="text-sm text-gray-600 mb-4">Mujer no embarazada, sin alteración funcional/anatómica vía urinaria.</p>
|
| 68 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 69 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Fosfomicina trometamol 3 g VO dosis única (toma nocturna). Puede repetirse a las 48-72h si persiste clínica.</p></div>
|
| 70 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Cefuroxima 250-500 mg/12h VO, 5 días.</p></div>
|
| 71 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Nitrofurantoína 100 mg/8h VO, 5 días.</p></div>
|
| 72 |
+
</div>
|
| 73 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Cistitis Simple</div><ul class="list-disc text-gray-700 space-y-1"><li>NO indicado urocultivo en cistitis no complicadas y no recidivantes.</li><li>Urocultivo SÍ indicado si: sospecha pielonefritis, síntomas recurrentes (2-4 sem post-tto), síntomas atípicos.</li><li><span class="font-bold text-red-600">NO USAR EMPÍRICAMENTE:</span> Quinolonas y Cotrimoxazol (TMP/SMX) por alta resistencia (~20%).</li><li><strong>Nitrofurantoína:</strong> NO usar si ClCr $< 50$ ml/min, ni en tto > 7 días o profilaxis. Evitar en 1er trimestre embarazo y a término si hay alternativas.</li></ul></div>
|
| 74 |
+
</div>
|
| 75 |
+
|
| 76 |
+
<div class="sub-category">
|
| 77 |
+
<h3 class="sub-category-title"><i class="fas fa-male text-blue-500 mr-2"></i><i class="fas fa-notes-medical text-red-500 mr-2"></i>Cistitis Complicada</h3>
|
| 78 |
+
<p class="text-sm text-gray-600 mb-4">Varón, infección reciente, insuficiencia renal, diabetes, anomalía vía urinaria.</p>
|
| 79 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Fosfomicina trometamol 3 g VO y repetir dosis a las 48-72h.</p></div>
|
| 81 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Cefuroxima 250-500 mg/12h VO, 7 días.</p></div>
|
| 82 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Nitrofurantoína 100 mg/8h VO, 7 días.</p></div>
|
| 83 |
+
</div>
|
| 84 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Cistitis Complicada</div><ul class="list-disc text-gray-700 space-y-1"><li>Urocultivo SIEMPRE pre-tratamiento y adecuar según antibiograma.</li><li>Duración total: 7 días.</li><li>No se recomienda urocultivo de control salvo persistencia/empeoramiento a las 48-72h.</li><li>En varones, descartar siempre prostatitis/epididimitis.</li><li><span class="font-bold text-red-600">NO USAR EMPÍRICAMENTE:</span> Quinolonas y Cotrimoxazol (TMP/SMX) por alta resistencia (~20%).</li><li><strong>Nitrofurantoína:</strong> NO usar si ClCr $< 50$ ml/min, ni en tto > 7 días o profilaxis. Evitar en 1er trimestre embarazo y a término si hay alternativas.</li></ul></div>
|
| 85 |
+
</div>
|
| 86 |
+
</div>
|
| 87 |
+
|
| 88 |
+
<div id="pielonefritis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 89 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-temperature-high text-red-600"></i> Pielonefritis Aguda</h2>
|
| 90 |
+
<p class="text-sm text-gray-600 mb-4">Síndrome miccional + fiebre y/o dolor fosa renal. Ancianos: clínica inespecífica (letargia, vómitos, dolor abdominal).</p>
|
| 91 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">E. coli (>80%)</span><span class="pathogen-item">Otras enterobacterias</span><span class="pathogen-item">S. saprophyticus</span><span class="pathogen-item">Pseudomonas aeruginosa (riesgo)</span><span class="pathogen-item">Enterococcus spp. (riesgo)</span><span class="pathogen-item">BLEES (riesgo)</span></div></div>
|
| 92 |
+
|
| 93 |
+
<div class="sub-category">
|
| 94 |
+
<h3 class="sub-category-title"><i class="fas fa-clinic-medical mr-2"></i>Sin Criterios de Ingreso</h3>
|
| 95 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 96 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Cefuroxima 500 mg/12h VO ó Cefixima 400 mg/24h VO (o 200 mg/12h VO), durante 7 días.<br>Considerar dosis inicial parenteral: Ceftriaxona 2g IV/IM ó Tobramicina 200mg IV/IM, reevaluar 6-24h y pasar a VO.</p></div>
|
| 97 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Tobramicina 200 mg IM/24h, 5 días.</p></div>
|
| 98 |
+
</div>
|
| 99 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones PNA Ambulatoria</div><ul class="list-disc text-gray-700 space-y-1"><li>Urocultivo SIEMPRE antes de iniciar tratamiento. Hemocultivo NO necesario.</li><li>Pruebas de imagen (ECO/TC) NO necesarias de rutina. SÍ si: no mejoría 48-72h, recurrencia, hematuria macroscópica, cólico, masa renal, IRA, shock, litiasis, malformación, inmunosupresión.</li><li>Analítica orina / urocultivo post-tratamiento no estrictamente necesarios (a decisión facultativo).</li></ul></div>
|
| 100 |
+
</div>
|
| 101 |
+
|
| 102 |
+
<div class="sub-category">
|
| 103 |
+
<h3 class="sub-category-title"><i class="fas fa-procedures text-red-700 mr-2"></i>Con Criterios de Ingreso</h3>
|
| 104 |
+
<p class="text-sm text-gray-600 mb-4">Sepsis, deterioro general, complicación local, patología base (inmunodeprimidos, neoplasia, cirrosis, ancianos), DM mal controlada, no respuesta a tto previo, no estabilidad 6-12h observación, no posible tto oral.</p>
|
| 105 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico (Sin Riesgo de Resistencias)</h4>
|
| 106 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Ceftriaxona 2 g/24h IV.</p></div>
|
| 107 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Tobramicina 200 mg/24h IV ó Aztreonam 1 g/8h IV.</p></div>
|
| 108 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-home text-purple-500"></i> Opción HaD (Hospitalización a Domicilio)</div><p class="text-gray-700">Ceftriaxona 2g/24h IV.</p></div>
|
| 109 |
+
</div>
|
| 110 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones PNA Ingreso (Sin Riesgo Resistencias)</div><ul class="list-disc text-gray-700 space-y-1"><li>Hemocultivo, urocultivo y prueba de imagen (ECO/TC).</li><li>Repetir imagen y cultivo si no respuesta en 48-72h.</li><li>Duración total tratamiento: 7-14 días.</li></ul></div>
|
| 111 |
+
</div>
|
| 112 |
+
|
| 113 |
+
<div class="sub-category">
|
| 114 |
+
<h3 class="sub-category-title"><i class="fas fa-shield-virus text-orange-600 mr-2"></i>Con Riesgo de Gérmenes Resistentes</h3>
|
| 115 |
+
<p class="text-sm text-gray-600 mb-4">Manipulación urológica reciente, sonda vesical permanente, tto AB IV 3 meses previos, infección intrahospitalaria, antecedentes gérmenes multiR (BLEES, Pseudomonas...).</p>
|
| 116 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 117 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV/6h (preferir si no atcds MultiR o si atcds Pseudomonas) <strong>ó</strong> Ertapenem 1 g IV/24h (preferir si atcds BLEE).</p></div>
|
| 118 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Amikacina 15-20 mg/kg/24h IV.</p></div>
|
| 119 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-home text-purple-500"></i> Opción HaD</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV/6h <strong>ó</strong> Ertapenem 1 g IV/24h +/- Amikacina 15-20 mg/kg/24h IV.</p></div>
|
| 120 |
+
</div>
|
| 121 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones PNA Ingreso (Con Riesgo Resistencias)</div><ul class="list-disc text-gray-700 space-y-1"><li>Hemocultivo, urocultivo y prueba de imagen (ECO/TC).</li><li>Duración total tratamiento: 7-14 días.</li></ul></div>
|
| 122 |
+
</div>
|
| 123 |
+
|
| 124 |
+
<div class="sub-category">
|
| 125 |
+
<h3 class="sub-category-title"><i class="fas fa-exclamation-triangle text-red-700 mr-2"></i>Con Signos de Sepsis Grave o Shock Séptico</h3>
|
| 126 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 127 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-users text-blue-600"></i> Paciente Comunitario SIN Riesgo Resistencias</div><p class="text-gray-700">Ceftriaxona 2g/24h IV + Amikacina 15-20 mg/kg IV en dosis única diaria.</p></div>
|
| 128 |
+
<div class="treatment-option border-orange-500"><div class="treatment-title"><i class="fas fa-shield-virus text-orange-600"></i> Paciente CON Riesgo Resistencias</div><p class="text-gray-700">Meropenem 1 g/8h IV <strong>ó</strong> Piperacilina/Tazobactam 4.5 g/6h IV<br><strong>+</strong> Amikacina 15 mg/kg/24h IV en dosis única diaria.</p></div>
|
| 129 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-allergies text-red-600"></i> Alternativa o Alergia Beta-lactámicos (en paciente con riesgo)</div><p class="text-gray-700">Aztreonam 2g/8h IV + Amikacina 15 mg/kg/24h IV.</p></div>
|
| 130 |
+
<div class="treatment-option border-purple-500"><div class="treatment-title"><i class="fas fa-plus-circle text-purple-600"></i> Añadir Cobertura Enterococcus spp (si factores riesgo*)</div><p class="text-gray-700">Vancomicina 20 mg/kg IV (dosis carga) y luego 15 mg/kg/12h (monitorizar niveles).<br><em>Si no monitorización Vanco:</em> Linezolid 600 mg/8h IV (día 1), luego 600 mg/12h IV.</p></div>
|
| 131 |
+
</div>
|
| 132 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones PNA Grave / Shock</div><ul class="list-disc text-gray-700 space-y-1"><li>*Factores Riesgo Enterococcus spp: ancianos, sonda vesical, tto AB previo amplio espectro (esp. Cefalosporinas).</li><li>Riesgo Resistencias: Manipulación urológica reciente, sonda vesical permanente, tto AB IV 3 meses previos, infección intrahospitalaria, antecedentes gérmenes multiR.</li><li>Hemocultivo, urocultivo y prueba de imagen (ECO/TC).</li><li>Duración total tratamiento: 7-14 días.</li><li>Ajustar siempre a funci��n renal.</li></ul></div>
|
| 133 |
+
</div>
|
| 134 |
+
</div>
|
| 135 |
+
|
| 136 |
+
<div id="prostatitis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 137 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-male text-blue-700"></i> Prostatitis Aguda</h2>
|
| 138 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">E. coli (más frecuente)</span><span class="pathogen-item">Proteus spp.</span><span class="pathogen-item">Klebsiella spp.</span><span class="pathogen-item">Otras enterobacterias</span><span class="pathogen-item">Pseudomonas aeruginosa</span><span class="pathogen-item">Enterococcus faecalis</span><span class="pathogen-item">N. gonorrhoeae (ETS)</span><span class="pathogen-item">Chlamydia trachomatis (ETS)</span></div></div>
|
| 139 |
+
|
| 140 |
+
<div class="sub-category">
|
| 141 |
+
<h3 class="sub-category-title"><i class="fas fa-clinic-medical mr-2"></i>Sin Criterios de Ingreso</h3>
|
| 142 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 143 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Cefuroxima 500 mg/12h VO ó Cefixima 400 mg/24h VO (o 200 mg/12h VO).<br>Considerar dosis inicial parenteral: Ceftriaxona 2g IV/IM ó Aminoglucósido (Tobramicina o Gentamicina 5-7 mg/kg/24h).</p></div>
|
| 144 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Tobramicina 5 mg/kg IV/IM dosis única, seguido de: Ciprofloxacino 750 mg/12h VO ó Trimetoprim/Sulfametoxazol (TMP/SMX) 160/800 mg/12h VO.</p></div>
|
| 145 |
+
</div>
|
| 146 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Prostatitis Aguda Ambulatoria</div><ul class="list-disc text-gray-700 space-y-1"><li>Tomar urocultivo antes de iniciar tratamiento.</li><li>En sexualmente activos considerar ETS (N. gonorrhoeae, Chlamydia...).</li><li><span class="font-bold">Duración total tratamiento: 4 semanas.</span></li><li>Tratamiento secuencial (pasar a VO si sensible): Ciprofloxacino 750 mg/12h ó TMP/SMX 160/800 mg/12h.</li></ul></div>
|
| 147 |
+
</div>
|
| 148 |
+
|
| 149 |
+
<div class="sub-category">
|
| 150 |
+
<h3 class="sub-category-title"><i class="fas fa-procedures text-red-700 mr-2"></i>Con Criterios de Ingreso</h3>
|
| 151 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico (Sin Riesgo Resistencias)</h4>
|
| 152 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Ceftriaxona 2 g/24h IV.</p></div>
|
| 153 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Aztreonam 1-2 g/8h IV + Amikacina 15 mg/kg/24h IV.</p></div>
|
| 154 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-home text-purple-500"></i> Opción HaD</div><p class="text-gray-700">Ceftriaxona 2g/24h IV ó [Aztreonam 1-2g/8h + Amikacina 15mg/kg/24h].</p></div>
|
| 155 |
+
</div>
|
| 156 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Prostatitis Ingreso (Sin Riesgo)</div><ul class="list-disc text-gray-700 space-y-1"><li>Solicitar urocultivo y hemocultivo.</li><li>Si no mejoría en 72h: solicitar imagen (ECO transrectal o TC) y repetir cultivos.</li><li><span class="font-bold">Duración total tratamiento: 4 semanas.</span></li><li>Tratamiento secuencial (pasar a VO si sensible): Ciprofloxacino 750 mg/12h ó TMP/SMX 160/800 mg/12h.</li></ul></div>
|
| 157 |
+
</div>
|
| 158 |
+
|
| 159 |
+
<div class="sub-category">
|
| 160 |
+
<h3 class="sub-category-title"><i class="fas fa-shield-virus text-orange-600 mr-2"></i>Con Riesgo de Gérmenes Resistentes</h3>
|
| 161 |
+
<p class="text-sm text-gray-600 mb-4">Manipulación urológica reciente, sonda vesical permanente, tto AB IV 3 meses previos, infección intrahospitalaria, antecedentes gérmenes multiR (BLEES, Pseudomonas...).</p>
|
| 162 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 163 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV/6h (preferir si no atcds MultiR o si atcds Pseudomonas) <strong>ó</strong> Ertapenem 1 g IV/24h (preferir si atcds BLEE).</p></div>
|
| 164 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Amikacina 15-20 mg/kg/24h IV.</p></div>
|
| 165 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-home text-purple-500"></i> Opción HaD</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV/6h <strong>ó</strong> Ertapenem 1 g IV/24h y/o Amikacina 15-20 mg/kg/24h IV.</p></div>
|
| 166 |
+
</div>
|
| 167 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Prostatitis Ingreso (Con Riesgo)</div><ul class="list-disc text-gray-700 space-y-1"><li>Solicitar urocultivo y hemocultivo.</li><li><span class="font-bold">Duración total tratamiento: 4 semanas.</span></li><li>Tratamiento secuencial (pasar a VO si sensible): Ciprofloxacino 750 mg/12h ó TMP/SMX 160/800 mg/12h.</li></ul></div>
|
| 168 |
+
</div>
|
| 169 |
+
|
| 170 |
+
<div class="sub-category">
|
| 171 |
+
<h3 class="sub-category-title"><i class="fas fa-exclamation-triangle text-red-700 mr-2"></i>Con Signos de Sepsis Grave o Shock Séptico</h3>
|
| 172 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 173 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-users text-blue-600"></i> Paciente Comunitario SIN Riesgo Resistencias</div><p class="text-gray-700">Ceftriaxona 2g/24h IV + Amikacina 15-20 mg/kg IV en dosis única diaria.</p></div>
|
| 174 |
+
<div class="treatment-option border-orange-500"><div class="treatment-title"><i class="fas fa-shield-virus text-orange-600"></i> Paciente CON Riesgo Resistencias</div><p class="text-gray-700">Meropenem 1 g/8h IV <strong>ó</strong> Piperacilina/Tazobactam 4.5 g/6h IV<br><strong>+</strong> Amikacina 15 mg/kg/24h IV en dosis única diaria.</p></div>
|
| 175 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-allergies text-red-600"></i> Alternativa o Alergia Beta-lactámicos (en paciente con riesgo)</div><p class="text-gray-700">Aztreonam 2g/8h IV + Amikacina 15 mg/kg/24h IV.</p></div>
|
| 176 |
+
<div class="treatment-option border-purple-500"><div class="treatment-title"><i class="fas fa-plus-circle text-purple-600"></i> Añadir Cobertura Enterococcus spp (si factores riesgo*)</div><p class="text-gray-700">Vancomicina 20 mg/kg IV (dosis carga) y luego 15 mg/kg/12h (monitorizar niveles).<br><em>Si no monitorización Vanco:</em> Linezolid 600 mg/8h IV (día 1), luego 600 mg/12h IV.</p></div>
|
| 177 |
+
</div>
|
| 178 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Prostatitis Grave / Shock</div><ul class="list-disc text-gray-700 space-y-1"><li>*Factores Riesgo Enterococcus spp: ancianos, sonda vesical, tto AB previo amplio espectro (esp. Cefalosporinas).</li><li>Riesgo Resistencias: Manipulación urológica reciente, sonda vesical permanente, tto AB IV 3 meses previos, infección intrahospitalaria, antecedentes gérmenes multiR.</li><li>Hemocultivo, urocultivo. Considerar imagen.</li><li><span class="font-bold">Duración total tratamiento: 4 semanas.</span></li><li>Tratamiento secuencial (pasar a VO si sensible): Ciprofloxacino 750 mg/12h ó TMP/SMX 160/800 mg/12h.</li><li>Ajustar siempre a función renal.</li></ul></div>
|
| 179 |
+
</div>
|
| 180 |
+
|
| 181 |
+
<div class="sub-category">
|
| 182 |
+
<h3 class="sub-category-title"><i class="fas fa-history text-gray-600 mr-2"></i>Prostatitis Crónica (duración > 3 meses)</h3>
|
| 183 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento</h4>
|
| 184 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-microscope text-blue-600"></i> Tratamiento DIRIGIDO (NO EMPÍRICO)</div><p class="text-gray-700">Basado en resultados de Microbiología.</p></div>
|
| 185 |
+
</div>
|
| 186 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Prostatitis Crónica</div><ul class="list-disc text-gray-700 space-y-1"><li>Etiología frecuente: Enterobacterias (E. coli), Pseudomonas aeruginosa, Enterococcus spp, S. aureus.</li><li>Duración del tratamiento: 4-6 semanas.</li></ul></div>
|
| 187 |
+
</div>
|
| 188 |
+
</div>
|
| 189 |
+
|
| 190 |
+
<div id="orquiepididimitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 191 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-male text-purple-700"></i> Orquiepididimitis</h2>
|
| 192 |
+
|
| 193 |
+
<div class="sub-category">
|
| 194 |
+
<h3 class="sub-category-title"><i class="fas fa-heart-broken text-pink-600 mr-2"></i>Sospecha ETS (Enfermedad Transmisión Sexual)</h3>
|
| 195 |
+
<p class="text-sm text-gray-600 mb-4">Considerar en varones jóvenes sexualmente activos.</p>
|
| 196 |
+
<div class="mb-4"><h4 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h4><div class="pathogen-list"><span class="pathogen-item">Chlamydia trachomatis</span><span class="pathogen-item">N. gonorrhoeae</span></div></div>
|
| 197 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 198 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">(Ceftriaxona 1g IM/IV dosis única <strong>+</strong> Doxiciclina 100 mg/12h VO 10 días) <strong>ó</strong> (Cefixima 400 mg VO dosis única <strong>+</strong> Doxiciclina 100 mg/12h VO 7 días).</p></div>
|
| 199 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Azitromicina 2g VO dosis única <strong>+</strong> Doxiciclina 100 mg/12h VO 7 días.</p></div>
|
| 200 |
+
</div>
|
| 201 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Orquiepididimitis (ETS)</div><ul class="list-disc text-gray-700 space-y-1"><li>Si se confirma C. trachomatis o N. gonorrhoeae: tratar a la pareja(s).</li><li>Urocultivo (orina media micción).</li><li>Si sospecha ITS: frotis uretral. Si no es posible, recoger muestra de orina uretral (primer chorro).</li></ul></div>
|
| 202 |
+
</div>
|
| 203 |
+
|
| 204 |
+
<div class="sub-category">
|
| 205 |
+
<h3 class="sub-category-title"><i class="fas fa-times-circle text-gray-600 mr-2"></i>Sin Sospecha ETS</h3>
|
| 206 |
+
<p class="text-sm text-gray-600 mb-4">Considerar en varones mayores o con antecedentes urológicos previos.</p>
|
| 207 |
+
<div class="mb-4"><h4 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h4><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Otras enterobacterias (BGN)</span></div></div>
|
| 208 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 209 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Cefuroxima 500 mg/12h VO ó Cefixima 400 mg/24h VO (o 200 mg/12h VO).<br>Considerar dosis inicial parenteral: Ceftriaxona 2g IV/IM ó Aminoglucósido (Tobramicina o Gentamicina 5-7 mg/kg/24h).</p></div>
|
| 210 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Tobramicina 5 mg/kg IV/IM dosis única, seguido de: Ciprofloxacino 750 mg/12h VO ó Trimetoprim/Sulfametoxazol (TMP/SMX) 160/800 mg/12h VO.</p></div>
|
| 211 |
+
</div>
|
| 212 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Orquiepididimitis (No ETS)</div><ul class="list-disc text-gray-700 space-y-1"><li>Urocultivo.</li><li>Ajustar a antibiograma, dando preferencia a TMP/SMX y fluoroquinolonas si son sensibles.</li><li>Duración del tratamiento: 2-3 semanas (valorar prostatitis asociada).</li></ul></div>
|
| 213 |
+
</div>
|
| 214 |
+
</div>
|
| 215 |
+
|
| 216 |
+
<div id="paciente_sondado" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 217 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-catheter text-teal-600"></i> Infección Urinaria en Paciente Sondado</h2>
|
| 218 |
+
<p class="text-sm text-gray-600 mb-4">La bacteriuria/candiduria asintomática en sondados NO se trata.</p>
|
| 219 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Otras Enterobacterias</span><span class="pathogen-item">Enterococcus spp.</span><span class="pathogen-item">Levaduras (Candida spp.)</span><span class="pathogen-item">Pseudomonas aeruginosa (riesgo)</span><span class="pathogen-item">BLEES (riesgo)</span></div></div>
|
| 220 |
+
|
| 221 |
+
<div class="sub-category">
|
| 222 |
+
<h3 class="sub-category-title"><i class="fas fa-clinic-medical mr-2"></i>Sin Criterios de Ingreso / Sin Riesgo Resistencias</h3>
|
| 223 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 224 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Revisar aislamientos previos. Si no hay: Cefuroxima 500 mg/12h VO ó Cefixima 400 mg/24h VO (o 200 mg/12h VO), 7 días.</p></div>
|
| 225 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Tobramicina 5 mg/kg IM/24h, 5-7 días.</p></div>
|
| 226 |
+
</div>
|
| 227 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Paciente Sondado (Leve)</div><ul class="list-disc text-gray-700 space-y-1"><li>Recambio de sonda SIEMPRE si lleva > 7 días.</li><li>Sedimento y urocultivo SIEMPRE tras cambio de sonda.</li><li>Si solo síntomas locales sin signos sistémicos: recomendable esperar resultado urocultivo.</li><li>Orina turbia o maloliente en asintomático NO es criterio de urocultivo ni tratamiento.</li><li>Ajustar tratamiento según urocultivo. Completar hasta 7 días totales.</li><li>Recordar: colonización 100% a los 30 días. Urocultivo positivo sin síntomas NO implica infección.</li></ul></div>
|
| 228 |
+
</div>
|
| 229 |
+
|
| 230 |
+
<div class="sub-category">
|
| 231 |
+
<h3 class="sub-category-title"><i class="fas fa-shield-virus text-orange-600 mr-2"></i>Con Riesgo de Gérmenes Resistentes</h3>
|
| 232 |
+
<p class="text-sm text-gray-600 mb-4">Manipulación urológica reciente, sonda vesical permanente, tto AB IV 3 meses previos, infección intrahospitalaria, antecedentes gérmenes multiR (BLEES, Pseudomonas...). Requiere ingreso.</p>
|
| 233 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 234 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV/6h (preferir si no atcds MultiR o si atcds Pseudomonas) <strong>ó</strong> Ertapenem 1 g IV/24h (preferir si atcds BLEE).</p></div>
|
| 235 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Amikacina 15-20 mg/kg/24h IV.</p></div>
|
| 236 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-home text-purple-500"></i> Opción HaD</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV/6h <strong>ó</strong> Ertapenem 1 g IV/24h ó Amikacina 15-20 mg/kg/24h IV.</p></div>
|
| 237 |
+
</div>
|
| 238 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Paciente Sondado (Con Riesgo)</div><ul class="list-disc text-gray-700 space-y-1"><li>Recambio de sonda SIEMPRE si lleva > 7 días.</li><li>Sedimento y urocultivo SIEMPRE tras cambio de sonda. Hemocultivos.</li><li>Si solo síntomas locales sin signos sistémicos: recomendable esperar resultado urocultivo.</li><li>Duración: Guiada por evolución y antibiograma (generalmente 7-14 días).</li></ul></div>
|
| 239 |
+
</div>
|
| 240 |
+
|
| 241 |
+
<div class="sub-category">
|
| 242 |
+
<h3 class="sub-category-title"><i class="fas fa-exclamation-triangle text-red-700 mr-2"></i>Con Signos de Sepsis Grave o Shock Séptico</h3>
|
| 243 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
|
| 244 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-check-circle text-red-600"></i> De elección</div><p class="text-gray-700">Meropenem 1 g/8h IV <strong>+</strong> Amikacina 15 mg/kg/24h IV (dosis única diaria) <strong>+</strong> Linezolid 600 mg/12h IV (o Vancomicina IV si niveles disponibles).</p></div>
|
| 245 |
+
<div class="treatment-option border-orange-500"><div class="treatment-title"><i class="fas fa-allergies text-orange-600"></i> Alternativa o Alergia Beta-lactámicos</div><p class="text-gray-700">Aztreonam 2 g/8h IV <strong>+</strong> Amikacina 15 mg/kg/24h IV <strong>+</strong> Vancomicina 20 mg/kg IV (dosis carga) y luego 15 mg/kg/12h IV (monitorizar niveles).<br><em>Si no monitorización Vanco:</em> usar Linezolid 600 mg/8h IV (día 1), luego 600 mg/12h IV.</p></div>
|
| 246 |
+
</div>
|
| 247 |
+
<div class="note-box mt-4"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Paciente Sondado (Grave / Shock)</div><ul class="list-disc text-gray-700 space-y-1"><li>Recambio de sonda SIEMPRE.</li><li>Sedimento y urocultivo SIEMPRE tras cambio de sonda. Hemocultivos antes de iniciar tratamiento.</li><li>Duración: Guiada por evolución y antibiograma (generalmente 7-14 días).</li><li>Ajustar siempre a función renal.</li></ul></div>
|
| 248 |
+
</div>
|
| 249 |
+
</div>
|
| 250 |
+
|
| 251 |
+
</div> <script>
|
| 252 |
+
const sel = document.getElementById('diagnosticSelector');
|
| 253 |
+
const res = document.getElementById('result');
|
| 254 |
+
const storage = document.getElementById('guide-content-storage');
|
| 255 |
+
sel.addEventListener('change', () => {
|
| 256 |
+
res.innerHTML = ''; // Limpia el resultado anterior
|
| 257 |
+
const id = sel.value;
|
| 258 |
+
if (!id) return; // Si se selecciona la opción vacía, no hacer nada
|
| 259 |
+
const node = storage.querySelector('#' + id);
|
| 260 |
+
if (node) {
|
| 261 |
+
// Clona el nodo del contenido y lo añade al área de resultados
|
| 262 |
+
res.appendChild(node.cloneNode(true));
|
| 263 |
+
} else {
|
| 264 |
+
// Opcional: Mostrar un mensaje si el contenido no se encuentra
|
| 265 |
+
res.innerHTML = `<p class="text-center text-red-500">Contenido para '${id}' no encontrado.</p>`;
|
| 266 |
+
}
|
| 267 |
+
});
|
| 268 |
+
</script>
|
| 269 |
+
|
| 270 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 271 |
+
<p>Basado en: GUÍA DE TRATAMIENTO EMPÍRICO DE INFECCIONES URINARIAS PC-15_AL(E)A-EP Rev. A (25/06/2024)</p>
|
| 272 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 273 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 274 |
+
<p class="mt-1 text-xs">Autores Guía Original: Marcela Castillo Jerez, Daniel Hijazo Gascón, Vicente Andrés Lázaro, Jesús Valero Milian, Marcos Díez Cornell.</p>
|
| 275 |
+
</div>
|
| 276 |
+
</div>
|
| 277 |
+
</body>
|
| 278 |
+
</html>
|
proa/neutropenia.html
ADDED
|
@@ -0,0 +1,180 @@
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Neutropenia Febril</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-vial text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Neutropenia Febril</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Situación</label>
|
| 33 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 34 |
+
<option value="">-- Selecciona una situación --</option>
|
| 35 |
+
<option value="hematologico_bajo_riesgo">Hematológico - Bajo Riesgo</option>
|
| 36 |
+
<option value="hematologico_alto_riesgo">Hematológico - Alto Riesgo</option>
|
| 37 |
+
<option value="hematologico_sepsis">Hematológico - Alto Riesgo con Sepsis</option>
|
| 38 |
+
<option value="oncologico_bajo_riesgo">Oncológico - Bajo Riesgo</option>
|
| 39 |
+
<option value="oncologico_alto_riesgo">Oncológico - Alto Riesgo</option>
|
| 40 |
+
<option value="oncologico_especificas">Oncológico - Alto Riesgo (Condiciones Específicas)</option>
|
| 41 |
+
</select>
|
| 42 |
+
</div>
|
| 43 |
+
<div id="result" class="space-y-6"></div>
|
| 44 |
+
<div id="guide-content-storage" class="hidden">
|
| 45 |
+
<!-- Hematológico Bajo Riesgo -->
|
| 46 |
+
<div id="hematologico_bajo_riesgo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 47 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-green-600"></i> Neutropenia Febril Hematológico - Bajo Riesgo</h2>
|
| 48 |
+
<div class="mb-6">
|
| 49 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos Frecuentes</h3>
|
| 50 |
+
<div class="pathogen-list">
|
| 51 |
+
<span class="pathogen-item">Enterobacterias</span>
|
| 52 |
+
<span class="pathogen-item">Pseudomonas aeruginosa</span>
|
| 53 |
+
</div>
|
| 54 |
+
</div>
|
| 55 |
+
<div class="mt-6">
|
| 56 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico Oral</h3>
|
| 57 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Levofloxacino 500 mg VO/24 h o Ciprofloxacino 750 mg VO/12 h + Amoxicilina/Clavulánico 875/125 mg VO/8 h (o Clindamicina 300-600 mg VO/8 h si alergia a betalactámicos).</p></div>
|
| 58 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Ciprofloxacino 750 mg VO/12 h + Cefixima 400 mg VO/24 h o Cefuroxima 500 mg VO/12 h.</p></div>
|
| 59 |
+
</div>
|
| 60 |
+
<div class="note-box mt-6">
|
| 61 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 62 |
+
<ul class="list-disc text-gray-700 space-y-1">
|
| 63 |
+
<li>Índice MASCC ≥ 21.</li>
|
| 64 |
+
<li>Neutrófilos > 100/mm³ sin factores de alto riesgo.</li>
|
| 65 |
+
<li>Duración: suspender si afebril > 48 h y sin foco identificado, mínimo 7 días si foco confirmado.</li>
|
| 66 |
+
<li>Extraer hemocultivos y muestras antes del tratamiento.</li>
|
| 67 |
+
<li>Manejo ambulatorio con seguimiento estrecho.</li>
|
| 68 |
+
</ul>
|
| 69 |
+
</div>
|
| 70 |
+
</div>
|
| 71 |
+
<!-- Hematológico Alto Riesgo -->
|
| 72 |
+
<div id="hematologico_alto_riesgo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 73 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-red-500"></i> Neutropenia Febril Hematológico - Alto Riesgo</h2>
|
| 74 |
+
<div class="mb-6">
|
| 75 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Sin Focalidad Aparente</h3>
|
| 76 |
+
<div class="pathogen-list">
|
| 77 |
+
<span class="pathogen-item">Bacilos Gram negativos</span>
|
| 78 |
+
<span class="pathogen-item">Actividad antipseudomónica</span>
|
| 79 |
+
</div>
|
| 80 |
+
</div>
|
| 81 |
+
<div class="mt-6">
|
| 82 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico IV</h3>
|
| 83 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-dot-circle text-blue-600"></i> Elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV c/6 h o Cefepime 2 g IV c/8 h o Ceftazidima 2 g IV c/8 h.</p></div>
|
| 84 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Vancomicina dosis inicial 20 mg/kg IV, luego 15 mg/kg IV c/12 h + Aztreonam 2 g IV c/8 h o Levofloxacino 750 mg IV/24 h + Amikacina 15-20 mg/kg IV/24 h.</p></div>
|
| 85 |
+
</div>
|
| 86 |
+
<div class="note-box mt-6">
|
| 87 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 88 |
+
<ul class="list-disc text-gray-700 space-y-1">
|
| 89 |
+
<li>Índice MASCC < 21.</li>
|
| 90 |
+
<li>Reevaluar a las 48-72 h, añadir amikacina o vancomicina si fiebre persistente.</li>
|
| 91 |
+
<li>Valorar sospecha fúngica con GMN sérico y TC tórax.</li>
|
| 92 |
+
</ul>
|
| 93 |
+
</div>
|
| 94 |
+
</div>
|
| 95 |
+
<!-- Hematológico Sepsis -->
|
| 96 |
+
<div id="hematologico_sepsis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 97 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-black"></i> Hematológico - Alto Riesgo con Sepsis</h2>
|
| 98 |
+
<div class="mb-6">
|
| 99 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Sin Focalidad Aparente</h3>
|
| 100 |
+
</div>
|
| 101 |
+
<div class="mt-6">
|
| 102 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 103 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Meropenem 1 g IV c/8 h + Amikacina 15-20 mg/kg IV/24 h + Vancomicina dosis inicial 20 mg/kg IV, luego 15 mg/kg IV c/12 h + Anfotericina B liposomal (o Caspofungina/Anidulafungina si no neumonía).</p></div>
|
| 104 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Vancomicina 20 mg/kg IV + Aztreonam 2 g IV c/8 h + Amikacina o Colistina ± Metronidazol si intrabdominal.</p></div>
|
| 105 |
+
</div>
|
| 106 |
+
<div class="note-box mt-6">
|
| 107 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 108 |
+
<ul class="list-disc text-gray-700 space-y-1">
|
| 109 |
+
<li>Quick SOFA ≥ 2 o disfunción orgánica.</li>
|
| 110 |
+
<li>Considerar criterios UCI y ajustar según cultivo.</li>
|
| 111 |
+
</ul>
|
| 112 |
+
</div>
|
| 113 |
+
</div>
|
| 114 |
+
<!-- Oncológico Bajo Riesgo -->
|
| 115 |
+
<div id="oncologico_bajo_riesgo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 116 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-green-600"></i> Neutropenia Febril Oncológico - Bajo Riesgo</h2>
|
| 117 |
+
<div class="mb-6">
|
| 118 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología</h3>
|
| 119 |
+
<div class="pathogen-list">
|
| 120 |
+
<span class="pathogen-item">Enterobacterias</span>
|
| 121 |
+
<span class="pathogen-item">Pseudomonas aeruginosa</span>
|
| 122 |
+
</div>
|
| 123 |
+
</div>
|
| 124 |
+
<div class="mt-6">
|
| 125 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico Oral</h3>
|
| 126 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Ciprofloxacino 750 mg VO/12 h + Amoxicilina/Clavulánico 875/125 mg VO/8 h.</p></div>
|
| 127 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Ciprofloxacino 750 mg VO/12 h + Clindamicina 600 mg VO/6 h.</p></div>
|
| 128 |
+
</div>
|
| 129 |
+
<div class="note-box mt-6">
|
| 130 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 131 |
+
<ul class="list-disc text-gray-700 space-y-1">
|
| 132 |
+
<li>MASCC ≥ 21 o escala CISNE bajo riesgo.</li>
|
| 133 |
+
<li>Primera dosis IV, luego paso a VO si estable.</li>
|
| 134 |
+
<li>Ambulatorio si neutropenia < 7 días y buen soporte.</li>
|
| 135 |
+
</ul>
|
| 136 |
+
</div>
|
| 137 |
+
</div>
|
| 138 |
+
<!-- Oncológico Alto Riesgo -->
|
| 139 |
+
<div id="oncologico_alto_riesgo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 140 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-red-500"></i> Neutropenia Febril Oncológico - Alto Riesgo</h2>
|
| 141 |
+
<div class="mb-6">
|
| 142 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Tratamiento Empírico IV</h3>
|
| 143 |
+
</div>
|
| 144 |
+
<div class="mt-6">
|
| 145 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV c/6-8 h o Imipenem 0.5-1 g IV c/6 h o Meropenem 1-2 g IV c/8 h + Amikacina 15-20 mg/kg IV/24 h si Quick SOFA ≥ 2.</p></div>
|
| 146 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Aztreonam 2 g IV c/8 h + Vancomicina 1 g IV c/12 h o Ciprofloxacino 400 mg IV c/12 h + Vancomicina 1 g IV c/12 h + Amikacina si SOFA ≥ 2.</p></div>
|
| 147 |
+
</div>
|
| 148 |
+
</div>
|
| 149 |
+
<!-- Oncológico Específicas -->
|
| 150 |
+
<div id="oncologico_especificas" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 151 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-purple-600"></i> Oncológico - Alto Riesgo (Condiciones Específicas)</h2>
|
| 152 |
+
<div class="mt-6 space-y-4">
|
| 153 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-plus-circle text-blue-600"></i> Historia de Colonización Pseudomonas</div><p class="text-gray-700">Añadir Amikacina 15 mg/kg IV/24 h o combinar Piperacilina/Tazobactam con Ciprofloxacino 400 mg IV/12 h.</p></div>
|
| 154 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-plus-circle text-red-600"></i> Sospecha MRSA, mucositis grave o foco SST</div><p class="text-gray-700">Añadir Vancomicina 15-20 mg/kg IV c/8-12 h o Linezolid 600 mg IV c/12 h o Daptomicina 6 mg/kg IV c/24 h.</p></div>
|
| 155 |
+
<div class="treatment-option border-yellow-500"><div class="treatment-title"><i class="fas fa-plus-circle text-yellow-600"></i> Enterocolitis/Perirectal</div><p class="text-gray-700">Añadir Metronidazol 500 mg IV c/6 h.</p></div>
|
| 156 |
+
<div class="treatment-option border-gray-500"><div class="treatment-title"><i class="fas fa-plus-circle text-gray-600"></i> Pseudomonas resistente carbapenémicos</div><p class="text-gray-700">Ceftolozano/Tazobactam 1.0/0.5 g IV c/8 h o Ceftazidima/Avibactam 2.0/0.5 g IV c/8 h.</p></div>
|
| 157 |
+
</div>
|
| 158 |
+
</div>
|
| 159 |
+
</div>
|
| 160 |
+
|
| 161 |
+
<script>
|
| 162 |
+
const sel = document.getElementById('diagnosticSelector');
|
| 163 |
+
const res = document.getElementById('result');
|
| 164 |
+
const storage = document.getElementById('guide-content-storage');
|
| 165 |
+
sel.addEventListener('change', () => {
|
| 166 |
+
res.innerHTML = '';
|
| 167 |
+
const id = sel.value;
|
| 168 |
+
if (!id) return;
|
| 169 |
+
const node = storage.querySelector('#' + id);
|
| 170 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 171 |
+
});
|
| 172 |
+
</script>
|
| 173 |
+
|
| 174 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 175 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 176 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 177 |
+
</div>
|
| 178 |
+
</div>
|
| 179 |
+
</body>
|
| 180 |
+
</html>
|
proa/oftalmologia.html
ADDED
|
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Oftálmicas</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-eye text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Oftálmicas</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Diagnóstico</label>
|
| 33 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 34 |
+
<option value="">-- Selecciona un diagnóstico --</option>
|
| 35 |
+
<option value="celulitis_preseptal_orbitaria">Celulitis Preseptal y Orbitaria</option>
|
| 36 |
+
<option value="endoftalmitis">Endoftalmitis</option>
|
| 37 |
+
<option value="queratitis_bacteriana">Queratitis Bacteriana</option>
|
| 38 |
+
<option value="queratitis_viral">Queratitis Vírica</option>
|
| 39 |
+
<option value="queratitis_fungica">Queratitis Fúngica</option>
|
| 40 |
+
</select>
|
| 41 |
+
</div>
|
| 42 |
+
<div id="result" class="space-y-6"></div>
|
| 43 |
+
<div id="guide-content-storage" class="hidden">
|
| 44 |
+
<!-- Celulitis Preseptal y Orbitaria -->
|
| 45 |
+
<div id="celulitis_preseptal_orbitaria" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 46 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-hospital text-red-500"></i> Celulitis Preseptal y Orbitaria</h2>
|
| 47 |
+
<div class="mb-6">
|
| 48 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 49 |
+
<ul class="list-disc text-gray-700 ml-6">
|
| 50 |
+
<li>Streptococcus spp, Staphylococcus spp</li>
|
| 51 |
+
<li>Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, anaerobios</li>
|
| 52 |
+
</ul>
|
| 53 |
+
</div>
|
| 54 |
+
<div class="mt-6">
|
| 55 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico IV</h3>
|
| 56 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Ceftriaxona 2 g IV c/12 h + Cloxacilina 2 g IV c/4-6 h.</p></div>
|
| 57 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia Beta-lactámicos</div><p class="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>
|
| 58 |
+
</div>
|
| 59 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-notes-medical text-yellow-500"></i> Observaciones</div>
|
| 60 |
+
<ul class="list-disc text-gray-700 ml-6">
|
| 61 |
+
<li>Hospitalización y antibioterapia IV inmediata.</li>
|
| 62 |
+
<li>Pruebas: hemograma, bioquímica, cultivo conjuntival, TC/RM de órbita.</li>
|
| 63 |
+
<li>Medidas de soporte: AINEs, compresas frías, elevación de cabeza, control glucemia.</li>
|
| 64 |
+
</ul>
|
| 65 |
+
</div>
|
| 66 |
+
</div>
|
| 67 |
+
<!-- Endoftalmitis -->
|
| 68 |
+
<div id="endoftalmitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 69 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-vial text-purple-600"></i> Endoftalmitis</h2>
|
| 70 |
+
<div class="mb-6">
|
| 71 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-info-circle text-blue-500"></i> Clasificación</h3>
|
| 72 |
+
<ul class="list-disc text-gray-700 ml-6">
|
| 73 |
+
<li>Exógena (tras cirugía/intravítreo) vs Endógena</li>
|
| 74 |
+
<li>Aguda (<6 sem) vs Crónica (>6 sem)</li>
|
| 75 |
+
</ul>
|
| 76 |
+
</div>
|
| 77 |
+
<div class="mt-6">
|
| 78 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription text-blue-500"></i> Tratamiento Intravitreo</h3>
|
| 79 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Vancomicina 1 mg/0.1 ml + Ceftazidima 2 mg/0.1 ml.</p></div>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia Beta-lactámicos</div><p class="text-gray-700">Amikacina 0.4 mg/0.1 ml intravítrea.</p></div>
|
| 81 |
+
</div>
|
| 82 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-notes-medical text-yellow-500"></i> Observaciones</div>
|
| 83 |
+
<ul class="list-disc text-gray-700 ml-6">
|
| 84 |
+
<li>Agregar anfotericina B o voriconazol intravítreo si hongos.</li>
|
| 85 |
+
<li>Posible vitrectomía si agudeza ≤ movimiento de manos.</li>
|
| 86 |
+
<li>Añadir terapia tópica/oral según evolución y antibiograma.</li>
|
| 87 |
+
</ul>
|
| 88 |
+
</div>
|
| 89 |
+
</div>
|
| 90 |
+
<!-- Queratitis Bacteriana -->
|
| 91 |
+
<div id="queratitis_bacteriana" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 92 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-clinic-medical text-blue-700"></i> Queratitis Bacteriana</h2>
|
| 93 |
+
<div class="mb-6">
|
| 94 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología y Gravedad</h3>
|
| 95 |
+
<ul class="list-disc text-gray-700 ml-6">
|
| 96 |
+
<li>+ Leve: Staph. epi, S. aureus, Strep spp.</li>
|
| 97 |
+
<li>+ Grave: Pseudomonas (LDC), Neisseria, Bacillus.</li>
|
| 98 |
+
</ul>
|
| 99 |
+
</div>
|
| 100 |
+
<div class="mt-6">
|
| 101 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Leve</div><p class="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>
|
| 102 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-red-500"></i> Grave</div><p class="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>
|
| 103 |
+
</div>
|
| 104 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-notes-medical text-yellow-500"></i> Observaciones</div>
|
| 105 |
+
<ul class="list-disc text-gray-700 ml-6">
|
| 106 |
+
<li>Evitar corticoides hasta 24-48 h tras antibiótico.</li>
|
| 107 |
+
<li>Diagnóstico: clínico y raspado corneal si indica.</li>
|
| 108 |
+
</ul>
|
| 109 |
+
</div>
|
| 110 |
+
</div>
|
| 111 |
+
<!-- Queratitis Vírica -->
|
| 112 |
+
<div id="queratitis_viral" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 113 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-virus text-purple-600"></i> Queratitis Vírica</h2>
|
| 114 |
+
<div class="mb-6">
|
| 115 |
+
<p class="text-gray-700">Incluye epitelial (dendrítica), neurotrófica, estromal inmune/necrotizante, endotelitis y uveítis anterior. Etiologías: VHS y VVZ.</p>
|
| 116 |
+
</div>
|
| 117 |
+
<div class="mt-6 space-y-4">
|
| 118 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-prescription text-blue-600"></i> Epitelial (dendrítica)</div><p class="text-gray-700">Aciclovir 3% pomada 5 v/d + colirio antibiótico (Tobramicina/Moxifloxacino). Ciclopéjico 1% si dolor.</p></div>
|
| 119 |
+
<div class="treatment-option border-teal-500"><div class="treatment-title"><i class="fas fa-prescription text-teal-600"></i> Neurotrófica</div><p class="text-gray-700">Suero autólogo 1 got a3v/d. Doxiciclina 100 mg/d. Corticoides t��picos + adyuvancia plasmática.</p></div>
|
| 120 |
+
<div class="treatment-option border-yellow-500"><div class="treatment-title"><i class="fas fa-prescription text-yellow-600"></i> Estromal inmune/necrotizante</div><p class="text-gray-700">Aciclovir tópico + corticoides tópicos. Antivirales orales y profilaxis antibiótica. Ciclopéjico si uveítis.</p></div>
|
| 121 |
+
<div class="treatment-option border-indigo-500"><div class="treatment-title"><i class="fas fa-prescription text-indigo-600"></i> Endotelitis/Uveítis Anterior</div><p class="text-gray-700">Aciclovir 3% + corticoides tópicos (prednisolona), antivirales orales (aciclovir/valaciclovir). Profilaxis prolongada 6-12 meses.</p></div>
|
| 122 |
+
</div>
|
| 123 |
+
</div>
|
| 124 |
+
<!-- Queratitis Fúngica -->
|
| 125 |
+
<div id="queratitis_fungica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 126 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-spa text-green-700"></i> Queratitis Fúngica</h2>
|
| 127 |
+
<div class="mb-6">
|
| 128 |
+
<p class="text-gray-700">Causadas por hongos filamentosos (Aspergillus, Fusarium) o levaduras (Candida).</p>
|
| 129 |
+
</div>
|
| 130 |
+
<div class="mt-6 space-y-4">
|
| 131 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-prescription text-red-600"></i> Filamentosos</div><p class="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>
|
| 132 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-prescription text-blue-600"></i> Levaduras</div><p class="text-gray-700">Anfotericina B 0.25% colirio: pauta similar. Alternativa Fluconazol tópico o flucitosina.</p></div>
|
| 133 |
+
<div class="treatment-option border-gray-500"><div class="treatment-title"><i class="fas fa-prescription text-gray-600"></i> Recalcitrante / Mixta</div><p class="text-gray-700">Natamicina + Anfotericina B; valorar inyecciones subconjuntivales/intrastromales y adjuntos de povidona o desbridamiento.</p></div>
|
| 134 |
+
</div>
|
| 135 |
+
</div>
|
| 136 |
+
</div>
|
| 137 |
+
<script>
|
| 138 |
+
const sel=document.getElementById('diagnosticSelector'), res=document.getElementById('result'), storage=document.getElementById('guide-content-storage');
|
| 139 |
+
sel.addEventListener('change',()=>{res.innerHTML='';const id=sel.value; if(!id)return; const node=storage.querySelector('#'+id); if(node)res.appendChild(node.cloneNode(true));});
|
| 140 |
+
</script>
|
| 141 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 142 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 143 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 144 |
+
</div>
|
| 145 |
+
</div>
|
| 146 |
+
</body>
|
| 147 |
+
</html>
|
proa/orl.html
ADDED
|
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones ORL</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-head-side-mask text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones ORL</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Síndrome/Infección</label>
|
| 33 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 34 |
+
<option value="">-- Selecciona un síndrome/infección --</option>
|
| 35 |
+
<option value="otitis_media">Otitis Media Aguda</option>
|
| 36 |
+
<option value="otitis_externa">Otitis Externa</option>
|
| 37 |
+
<option value="faringoamigdalitis">Faringoamigdalitis</option>
|
| 38 |
+
<option value="rinosinusitis">Rinosinusitis Aguda</option>
|
| 39 |
+
<option value="otomastoiditis">Otomastoiditis</option>
|
| 40 |
+
<option value="flemon">Flemón Periamigdalino/Parafaríngeo</option>
|
| 41 |
+
<option value="candidiasis_oral">Candidiasis Oral</option>
|
| 42 |
+
<option value="gingivoestomatitis">Gingivoestomatitis Herpética</option>
|
| 43 |
+
<option value="herpes_labial">Herpes Labial</option>
|
| 44 |
+
<option value="infodont_sin">Infección Odontogénica sin Ingreso</option>
|
| 45 |
+
<option value="infodont_con">Infección Odontogénica con Ingreso</option>
|
| 46 |
+
<option value="gingivitis_aguda">Gingivitis Aguda</option>
|
| 47 |
+
<option value="sialoadenitis">Sialoadenitis Aguda</option>
|
| 48 |
+
<option value="absceso_cutaneo">Absceso Cutáneo Cervicofacial</option>
|
| 49 |
+
<option value="fascitis">Fascitis Necrotizante Cervicofacial</option>
|
| 50 |
+
</select>
|
| 51 |
+
</div>
|
| 52 |
+
<div id="result" class="space-y-6"></div>
|
| 53 |
+
<div id="guide-content-storage" class="hidden">
|
| 54 |
+
<!-- Otitis Media -->
|
| 55 |
+
<div id="otitis_media" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 56 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-ear text-yellow-600"></i> Otitis Media Aguda</h2>
|
| 57 |
+
<div class="pathogen-list"><span class="pathogen-item">S. pneumoniae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">M. catarrhalis</span><span class="pathogen-item">Streptococo A</span></div>
|
| 58 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Amoxicilina 1 g VO c/8 h (si criterios).</p></div>
|
| 59 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Segunda línea</div><p class="text-gray-700">Amoxicilina/Clavulánico 875/125 mg VO c/8 h o Cefditoreno 400 mg VO c/12 h.</p></div>
|
| 60 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Duración: 10 días.</li><li>Criterios: fiebre >39 °C, otalgia intensa, sin mejoría en 48 h.</li></ul></div>
|
| 61 |
+
</div>
|
| 62 |
+
<!-- Otitis Externa -->
|
| 63 |
+
<div id="otitis_externa" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 64 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-water text-blue-600"></i> Otitis Externa</h2>
|
| 65 |
+
<div class="pathogen-list"><span class="pathogen-item">Pseudomonas spp</span><span class="pathogen-item">S. aureus</span></div>
|
| 66 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección tópica</div><p class="text-gray-700">Ciprofloxacino gotas 4 gotas c/8 h ± corticoides.</p></div>
|
| 67 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Fúngica</div><p class="text-gray-700">Clotrimazol gotas c/8 h o Clioquinol ótico 0.25 mg c/8 h.</p></div>
|
| 68 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Evitar humedad y manipulación.</li><li>VO solo si extensión o tejidos blandos.</li></ul></div>
|
| 69 |
+
</div>
|
| 70 |
+
<!-- Faringoamigdalitis -->
|
| 71 |
+
<div id="faringoamigdalitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 72 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-throat text-red-500"></i> Faringoamigdalitis</h2>
|
| 73 |
+
<div class="pathogen-list"><span class="pathogen-item">Virus</span><span class="pathogen-item">Streptococo A</span></div>
|
| 74 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Penicilina V 500-800 mg VO c/12 h o Amoxicilina 1 g VO c/8 h.</p></div>
|
| 75 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alergia</div><p class="text-gray-700">Clindamicina 300 mg VO c/8 h o Claritromicina 500 mg VO c/12 h.</p></div>
|
| 76 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Duración: 7-10 días. Sintomático en virosis.</p></div>
|
| 77 |
+
</div>
|
| 78 |
+
<!-- Rinosinusitis -->
|
| 79 |
+
<div id="rinosinusitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 80 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-nose text-green-600"></i> Rinosinusitis Aguda</h2>
|
| 81 |
+
<div class="pathogen-list"><span class="pathogen-item">S. pneumoniae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">M. catarrhalis</span></div>
|
| 82 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Amoxicilina 1 g VO c/8 h 10 días.</p></div>
|
| 83 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Sin mejoría 48 h</div><p class="text-gray-700">Amoxicilina/Clavulánico 875/125 mg VO c/8 h o Cefditoreno 400 mg VO c/12 h.</p></div>
|
| 84 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Solo antibiótico si secreción purulenta o dolor intenso.</li><li>Otros: lavados nasales, descongestionantes.</li></ul></div>
|
| 85 |
+
</div>
|
| 86 |
+
<!-- Otomastoiditis -->
|
| 87 |
+
<div id="otomastoiditis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 88 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bone text-indigo-600"></i> Otomastoiditis</h2>
|
| 89 |
+
<div class="pathogen-list"><span class="pathogen-item">S. pneumoniae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">M. catarrhalis</span><span class="pathogen-item">Streptococo A</span></div>
|
| 90 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección IV</div><p class="text-gray-700">Amoxicilina/Clavulánico 1g/200 mg IV c/8 h o Ceftriaxona 1-2 g IV/24 h o Cefotaxima 1-2 g IV c/8 h.</p></div>
|
| 91 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p class="text-gray-700">Levofloxacino 500 mg IV/24 h.</p></div>
|
| 92 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Ingreso y valoración por ORL.</p></div>
|
| 93 |
+
</div>
|
| 94 |
+
<!-- Flemón -->
|
| 95 |
+
<div id="flemon" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 96 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-red-600"></i> Flemón Periamigdalino/Parafaríngeo</h2>
|
| 97 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span></div>
|
| 98 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección IV</div><p class="text-gray-700">Amoxicilina/Clavulánico 1g/200 mg IV c/8 h.</p></div>
|
| 99 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-procedures text-purple-500"></i> Riesgo SARM</div><p class="text-gray-700">Ertapenem 1 g IV/24 h ± Vancomicina 15‑20 mg/kg IV c/8‑12 h.</p></div>
|
| 100 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Drenaje absceso si procede.</li><li>TAC cervical si mala evolución.</li></ul></div>
|
| 101 |
+
</div>
|
| 102 |
+
<!-- Candidiasis Oral -->
|
| 103 |
+
<div id="candidiasis_oral" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 104 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-utensils text-pink-500"></i> Candidiasis Oral</h2>
|
| 105 |
+
<div class="pathogen-list"><span class="pathogen-item">Candida spp</span></div>
|
| 106 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Nistatina 5 ml VO enjuagar y tragar c/6-8 h x7 días.</p></div>
|
| 107 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Fluconazol 50-100 mg VO/día x7 días.</p></div>
|
| 108 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Cultivo si repetición o no respuesta.</p></div>
|
| 109 |
+
</div>
|
| 110 |
+
<!-- Gingivoestomatitis -->
|
| 111 |
+
<div id="gingivoestomatitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 112 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-virus text-red-600"></i> Gingivoestomatitis Herpética</h2>
|
| 113 |
+
<div class="pathogen-list"><span class="pathogen-item">VHS</span></div>
|
| 114 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Aciclovir 400 mg VO 5 veces/día x7 días.</p></div>
|
| 115 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> IV si intolerancia</div><p class="text-gray-700">Aciclovir 5 mg/kg IV c/8 h.</p></div>
|
| 116 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Úlceras múltiples, fiebre, difícil ingesta.</p></div>
|
| 117 |
+
</div>
|
| 118 |
+
<!-- Herpes Labial -->
|
| 119 |
+
<div id="herpes_labial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 120 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-kiss text-pink-600"></i> Herpes Labial</h2>
|
| 121 |
+
<div class="pathogen-list"><span class="pathogen-item">VHS</span></div>
|
| 122 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Aciclovir 400 mg VO 5x/día x5 días o tópico 5% 4x/día x4 días.</p></div>
|
| 123 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Recurrencias >6/año: famciclovir o valaciclovir profiláctico.</p></div>
|
| 124 |
+
</div>
|
| 125 |
+
<!-- Inf. Odontogénica Sin Ingreso -->
|
| 126 |
+
<div id="infodont_sin" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 127 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-yellow-700"></i> Infección Odontogénica sin Ingreso</h2>
|
| 128 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span></div>
|
| 129 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Amoxicilina/Clavulánico 875/125 mg VO c/8 h x5-7 días.</p></div>
|
| 130 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alergia</div><p class="text-gray-700">Clindamicina 300 mg VO c/6 h o Metronidazol 500 mg VO c/8 h o Moxifloxacino 400 mg VO/24 h.</p></div>
|
| 131 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Drenar foco y/o exodoncia si necesario.</li><li>Duración 5-7 días.</li></ul></div>
|
| 132 |
+
</div>
|
| 133 |
+
<!-- Inf. Odontogénica Con Ingreso -->
|
| 134 |
+
<div id="infodont_con" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 135 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-red-700"></i> Infección Odontogénica con Ingreso</h2>
|
| 136 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span><span class="pathogen-item">Actinobacillus</span><span class="pathogen-item">Porphyromonas</span></div>
|
| 137 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección IV</div><p class="text-gray-700">Amoxicilina/Clavulánico 1g/200 mg IV c/8 h + Gentamicina 240 mg IV/24 h.</p></div>
|
| 138 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Clindamicina 600 mg IV c/8 h o Moxifloxacino 400 mg IV/24 h o Vancomicina 1g IV c/12 h + Metronidazol 500 mg IV c/8 h.</p></div>
|
| 139 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Ingresar y reevaluar 24-48 h.</li><li>Hidratación, masaje glandular, antiinflamatorios.</li></ul></div>
|
| 140 |
+
</div>
|
| 141 |
+
<!-- Gingivitis Aguda -->
|
| 142 |
+
<div id="gingivitis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 143 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-green-800"></i> Gingivitis Aguda</h2>
|
| 144 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span></div>
|
| 145 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección VO</div><p class="text-gray-700">Amoxicilina/Clavulánico 875/125 mg VO c/8 h.</p></div>
|
| 146 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alergia</div><p class="text-gray-700">Clindamicina 300 mg VO c/6 h.</p></div>
|
| 147 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Higiene oral intensa, enjuagues clorhexidina 0.12%.</li></ul></div>
|
| 148 |
+
</div>
|
| 149 |
+
<!-- Sialoadenitis -->
|
| 150 |
+
<div id="sialoadenitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 151 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-syringe text-indigo-700"></i> Sialoadenitis Aguda Supurada</h2>
|
| 152 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. pneumoniae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">E. coli</span></div>
|
| 153 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección VO</div><p class="text-gray-700">Amoxicilina/Clavulánico 875/125 mg c/8 h + Metronidazol 500 mg c/8 h.</p></div>
|
| 154 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alergia</div><p class="text-gray-700">Clindamicina 600 mg IV c/8 h o Moxifloxacino 400 mg VO/24 h.</p></div>
|
| 155 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Hidratación, calor local, masaje glandular, antiinflamatorios.</li></ul></div>
|
| 156 |
+
</div>
|
| 157 |
+
<!-- Absceso Cutáneo -->
|
| 158 |
+
<div id="absceso_cutaneo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 159 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-cut text-red-500"></i> Absceso Cutáneo Cervicofacial</h2>
|
| 160 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span></div>
|
| 161 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección VO</div><p class="text-gray-700">Amoxicilina/Clavulánico 875/125 mg VO c/8 h x7 días.</p></div>
|
| 162 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alergia</div><p class="text-gray-700">Clindamicina 300 mg VO c/6 h x7 días.</p></div>
|
| 163 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Drenaje de absceso si procede.</p></div>
|
| 164 |
+
</div>
|
| 165 |
+
<!-- Fascitis Necrotizante -->
|
| 166 |
+
<div id="fascitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 167 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-skull-crossbones text-black"></i> Fascitis Necrotizante Cervicofacial</h2>
|
| 168 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span><span class="pathogen-item">Streptococo A</span><span class="pathogen-item">Enterobacterias</span></div>
|
| 169 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección IV</div><p class="text-gray-700">Piperacilina/Tazobactam 4g/0.5g IV c/6 h + Clindamicina 600 mg IV c/6 h.</p></div>
|
| 170 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Meropenem 1 g IV c/8 h + Clindamicina o Linezolid 600 mg IV c/12 h.</p></div>
|
| 171 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Ingresar y desbridamiento quirúrgico urgente.</p></div>
|
| 172 |
+
</div>
|
| 173 |
+
</div>
|
| 174 |
+
<script>
|
| 175 |
+
const sel = document.getElementById('diagnosticSelector');
|
| 176 |
+
const res = document.getElementById('result');
|
| 177 |
+
const storage = document.getElementById('guide-content-storage');
|
| 178 |
+
sel.addEventListener('change', () => {
|
| 179 |
+
res.innerHTML = '';
|
| 180 |
+
const id = sel.value;
|
| 181 |
+
if (!id) return;
|
| 182 |
+
const node = storage.querySelector('#' + id);
|
| 183 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 184 |
+
});
|
| 185 |
+
</script>
|
| 186 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 187 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 188 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 189 |
+
</div>
|
| 190 |
+
</div>
|
| 191 |
+
</body>
|
| 192 |
+
</html>
|
proa/orl_pediatrico.html
ADDED
|
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| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones ORL Pediátricas</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-green-600 p-2 rounded-lg text-white"><i class="fas fa-child text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones ORL Pediátricas</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Episodio</label>
|
| 33 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-green-500 focus:border-green-500">
|
| 34 |
+
<option value="">-- Selecciona un episodio --</option>
|
| 35 |
+
<option value="faringoamigdalitis">Faringoamigdalitis Aguda</option>
|
| 36 |
+
<option value="otitis_media">Otitis Media Aguda</option>
|
| 37 |
+
<option value="otitis_externa">Otitis Externa</option>
|
| 38 |
+
<option value="sinusitis">Sinusitis</option>
|
| 39 |
+
</select>
|
| 40 |
+
</div>
|
| 41 |
+
<div id="result" class="space-y-6"></div>
|
| 42 |
+
<div id="guide-content-storage" class="hidden">
|
| 43 |
+
<!-- Faringoamigdalitis Aguda -->
|
| 44 |
+
<div id="faringoamigdalitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 45 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-throat text-red-600"></i> Faringoamigdalitis Aguda</h2>
|
| 46 |
+
<div class="pathogen-list"><span class="pathogen-item">Viral (mayoría)</span><span class="pathogen-item">S. pyogenes</span></div>
|
| 47 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Penicilina V: 250 mg (<27 kg) o 500 mg (>27 kg) VO c/12 h x10 días.</p></div>
|
| 48 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Amoxicilina 25 mg/kg VO c/12 h x10 días.</p></div>
|
| 49 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-syringe text-purple-500"></i> IM (única dosis)</div><p class="text-gray-700">Penicilina benzatina: 600 000 UI (<27 kg) o 1 200 000 UI (>27 kg).</p></div>
|
| 50 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia penicilinas</div><p class="text-gray-700">Azitromicina 10 mg/kg VO d/1 x5 días o Josamicina 20 mg/kg VO c/12 h x10 días.</p></div>
|
| 51 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div>
|
| 52 |
+
<ul class="list-disc text-gray-700">
|
| 53 |
+
<li>Centor-McIsaac ≥ 3 o test rápido positivo.</li>
|
| 54 |
+
<li>En <3 años y criterios extras, también test o cultivo.</li>
|
| 55 |
+
</ul>
|
| 56 |
+
</div>
|
| 57 |
+
</div>
|
| 58 |
+
<!-- Otitis Media Aguda -->
|
| 59 |
+
<div id="otitis_media" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 60 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-ear text-yellow-700"></i> Otitis Media Aguda</h2>
|
| 61 |
+
<div class="pathogen-list"><span class="pathogen-item">S. pneumoniae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">M. catarrhalis</span></div>
|
| 62 |
+
<!-- <2 meses -->
|
| 63 |
+
<div class="note-box mb-4"><div class="note-title"><i class="fas fa-hospital text-red-500"></i> <2 meses</div><p class="text-gray-700">Ingreso. Si afebril y bien: Amox/Clav 40 mg/kg VO c/12 h + observación 2-3 días. Si fiebre o mal estado: Cefotaxima 50 mg/kg IV c/6 h o Amox/Clav 12.5 mg/kg IV c/8 h.</p></div>
|
| 64 |
+
<!-- 2-6 meses -->
|
| 65 |
+
<div class="note-box mb-4"><div class="note-title"><i class="fas fa-child text-green-600"></i> 2-6 meses</div><p class="text-gray-700">Amox/Clav 40 mg/kg VO c/12 h x10 días.</p></div>
|
| 66 |
+
<!-- 6m-2a -->
|
| 67 |
+
<div class="note-box mb-4"><div class="note-title"><i class="fas fa-medkit text-blue-600"></i> 6 m-2 años</div><p class="text-gray-700">Síntomas leves sin riesgo: analgésico 48-72 h y reevaluar; si empeora: Amoxicilina 40 mg/kg VO c/12 h x7-10 días. Riesgo o certeza: Amox/Clav 40-45 mg/kg VO c/12 h x10 días.</p></div>
|
| 68 |
+
<!-- >2 años -->
|
| 69 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-check-circle text-green-600"></i> >2 años</div><p class="text-gray-700">Leve: analgésico y reevaluar; si persiste: Amoxicilina 40 mg/kg VO c/12 h x5 días. Grave o riesgo: Amoxicilina 40-45 mg/kg VO c/12 h x7-10 días.</p>
|
| 70 |
+
<ul class="list-disc text-gray-700 mt-2"><li>Alergia no anafiláctica: Cefuroxima axetilo 15 mg/kg VO c/12 h x10 días.</li><li>Alergia tipo 1: Azitromicina o Claritromicina según sospecha.</li></ul>
|
| 71 |
+
</div>
|
| 72 |
+
</div>
|
| 73 |
+
<!-- Otitis Externa -->
|
| 74 |
+
<div id="otitis_externa" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 75 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-water text-blue-600"></i> Otitis Externa</h2>
|
| 76 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus (furúnculo)</span><span class="pathogen-item">P. aeruginosa</span></div>
|
| 77 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Tópico</div><p class="text-gray-700">Ciprofloxacino gotas 4-6 gotas c/8 h x5-7 días + calor local y analgesia. Evitar agua.</p></div>
|
| 78 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Sistémico</div><p class="text-gray-700">Cloxacilina o Amox/Clav VO x7 días si extensión o compromiso general.</p></div>
|
| 79 |
+
</div>
|
| 80 |
+
<!-- Sinusitis -->
|
| 81 |
+
<div id="sinusitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 82 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-nose text-green-600"></i> Sinusitis</h2>
|
| 83 |
+
<div class="pathogen-list"><span class="pathogen-item">S. pneumoniae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">M. catarrhalis</span></div>
|
| 84 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Amoxicilina 40-45 mg/kg VO c/12 h x10 días; si riesgo: Amox/Clav 40-45 mg/kg c/12 h x10 días.</p></div>
|
| 85 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p class="text-gray-700">No anafiláctica: Cefuroxima axetilo 15 mg/kg VO c/12 h x10 días; Tipo 1: Azitromicina o Claritromicina según edad.</p></div>
|
| 86 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Expectante 3 días si leve; antibiótico si no mejora o empeora.</p></div>
|
| 87 |
+
</div>
|
| 88 |
+
</div>
|
| 89 |
+
|
| 90 |
+
<script>
|
| 91 |
+
const sel = document.getElementById('diagnosticSelector');
|
| 92 |
+
const res = document.getElementById('result');
|
| 93 |
+
const storage = document.getElementById('guide-content-storage');
|
| 94 |
+
sel.addEventListener('change', () => {
|
| 95 |
+
res.innerHTML = '';
|
| 96 |
+
const id = sel.value;
|
| 97 |
+
if (!id) return;
|
| 98 |
+
const node = storage.querySelector('#' + id);
|
| 99 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 100 |
+
});
|
| 101 |
+
</script>
|
| 102 |
+
|
| 103 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 104 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 105 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 106 |
+
</div>
|
| 107 |
+
</div>
|
| 108 |
+
</body>
|
| 109 |
+
</html>
|
proa/osteoarticular.html
ADDED
|
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| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Osteoarticulares</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-800 p-2 rounded-lg text-white"><i class="fas fa-bone text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Osteoarticulares</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="conditionSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Patología</label>
|
| 33 |
+
<select id="conditionSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-800 focus:border-blue-800">
|
| 34 |
+
<option value="">-- Selecciona una patología --</option>
|
| 35 |
+
<option value="bursitis">Bursitis Infecciosa</option>
|
| 36 |
+
<option value="artritis_comunitaria">Artritis Infecciosa - Comunitaria</option>
|
| 37 |
+
<option value="artritis_nosocomial">Artritis Infecciosa - Nosocomial/Post-Infiltración</option>
|
| 38 |
+
<option value="artritis_mordedura">Artritis Infecciosa - Herida Penetrante/Mordedura</option>
|
| 39 |
+
<option value="espondilo_comunitaria">Espondilodiscitis/Osteomielitis Aguda - Comunitaria</option>
|
| 40 |
+
<option value="espondilo_nosocomial">Espondilodiscitis/Osteomielitis Aguda - Nosocomial</option>
|
| 41 |
+
<option value="pie_punzante">Osteomielitis Aguda - Pie Punzante</option>
|
| 42 |
+
<option value="insuf_vascular">Osteomielitis - Insuficiencia Vascular</option>
|
| 43 |
+
<option value="osteomielitis_cronica">Osteomielitis Crónica</option>
|
| 44 |
+
<option value="prot_precoz">Infección Protésica - Precoz</option>
|
| 45 |
+
<option value="prot_hematogena">Infección Protésica - Hematógena Aguda</option>
|
| 46 |
+
<option value="prot_cronica">Infección Protésica - Crónica Tardía</option>
|
| 47 |
+
</select>
|
| 48 |
+
</div>
|
| 49 |
+
<div id="result" class="space-y-6"></div>
|
| 50 |
+
<div id="guide-content-storage" class="hidden">
|
| 51 |
+
<!-- Bursitis Infecciosa -->
|
| 52 |
+
<div id="bursitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 53 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-water text-blue-800"></i> Bursitis Infecciosa</h2>
|
| 54 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Estreptococos</span><span class="pathogen-item">Bacilos G(-)</span></div>
|
| 55 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Sin ingreso</div><p class="text-gray-700">Cefadroxilo 1 g VO c/12 h. Si SARM: Linezolid 600 mg VO c/12 h.</p></div>
|
| 56 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-hospital text-red-500"></i> Con ingreso</div><p class="text-gray-700">Cefazolina 2 g IV c/8 h. Si SARM: Daptomicina 8-10 mg/kg IV/24 h.</p></div>
|
| 57 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Duración 7-14 días según evolución.</li><li>Valorar punción o drenaje si no mejora en 48 h.</li></ul></div>
|
| 58 |
+
</div>
|
| 59 |
+
<!-- Artritis Comunitaria -->
|
| 60 |
+
<div id="artritis_comunitaria" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 61 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-hand-paper text-red-700"></i> Artritis Infecciosa - Comunitaria</h2>
|
| 62 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Estreptococos</span><span class="pathogen-item">N. gonorrhoeae</span><span class="pathogen-item">Bacilos G(-)</span></div>
|
| 63 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección IV</div><p class="text-gray-700">Cloxacilina 2 g IV c/4 h + Ceftriaxona 2 g IV/24 h.</p></div>
|
| 64 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia BL</div><p class="text-gray-700">Aztreonam 2 g IV c/8 h + Linezolid 600 mg IV c/12 h.</p></div>
|
| 65 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Artrocentesis y hemocultivos iniciales.</li><li>Drenaje quirúrgico precoz; 4-6 semanas de ATB para S. aureus.</li></ul></div>
|
| 66 |
+
</div>
|
| 67 |
+
<!-- Artritis Nosocomial -->
|
| 68 |
+
<div id="artritis_nosocomial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 69 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-purple-600"></i> Artritis Infecciosa - Nosocomial/Post-Infiltración</h2>
|
| 70 |
+
<div class="pathogen-list"><span class="pathogen-item">Staf. Coagulasa-neg.</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">P. aeruginosa</span><span class="pathogen-item">Cutibacterium acnes</span></div>
|
| 71 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Daptomicina 8-10 mg/kg IV/24 h + Ceftazidima 2 g IV c/8 h.</p></div>
|
| 72 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia BL</div><p class="text-gray-700">Daptomicina + Aztreonam 2 g IV c/8 h.</p></div>
|
| 73 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Artrocentesis y drenaje repetido; 4-6 semanas de tratamiento.</p></div>
|
| 74 |
+
</div>
|
| 75 |
+
<!-- Artritis Herida -->
|
| 76 |
+
<div id="artritis_mordedura" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 77 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-green-800"></i> Artritis Infecciosa - Herida/Mordedura</h2>
|
| 78 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span><span class="pathogen-item">Pasteurella spp.</span><span class="pathogen-item">Eikenella corrodens</span></div>
|
| 79 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Sin ingreso</div><p class="text-gray-700">Amox/Clav 875/125 mg VO c/8 h.</p></div>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-hospital text-red-500"></i> Con ingreso</div><p class="text-gray-700">Amox/Clav 2 g IV c/8 h ± Metronidazol 500 mg IV c/8 h.</p></div>
|
| 81 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div>
|
| 82 |
+
<p class="text-gray-700">Artrocentesis y drenaje; 4-6 semanas tratamiento según germen.</p>
|
| 83 |
+
</div>
|
| 84 |
+
</div>
|
| 85 |
+
<!-- Espondilodiscitis Comunitaria -->
|
| 86 |
+
<div id="espondilo_comunitaria" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 87 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-spine text-indigo-600"></i> Espondilodiscitis/Osteomielitis Aguda - Comunitaria</h2>
|
| 88 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Estreptococos</span><span class="pathogen-item">Bacilos G(-)</span></div>
|
| 89 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección</div><p class="text-gray-700">Cloxacilina 2 g IV c/4 h + Ceftriaxona 2 g IV/24 h.</p></div>
|
| 90 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia BL</div><p class="text-gray-700">Aztreonam 2 g IV c/8 h + Linezolid 600 mg IV c/12 h.</p></div>
|
| 91 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div>
|
| 92 |
+
<ul class="list-disc text-gray-700">
|
| 93 |
+
<li>Hemocultivos y biopsia ósea pre-ATB.</li>
|
| 94 |
+
<li>Duración ≥ 6 semanas; valorar cirugía si abscesos.</li>
|
| 95 |
+
</ul>
|
| 96 |
+
</div>
|
| 97 |
+
</div>
|
| 98 |
+
<!-- Espondilodiscitis Nosocomial -->
|
| 99 |
+
<div id="espondilo_nosocomial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 100 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-hospital text-red-600"></i> Espondilodiscitis/Osteomielitis Aguda - Nosocomial</h2>
|
| 101 |
+
<div class="pathogen-list"><span class="pathogen-item">Staf. Coag-neg.</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">P. aeruginosa</span></div>
|
| 102 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Daptomicina 8-10 mg/kg IV/24 h + Ceftazidima 2 g IV c/8 h.</p></div>
|
| 103 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia BL</div><p class="text-gray-700">Daptomicina + Aztreonam 2 g IV c/8 h.</p></div>
|
| 104 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Hemocultivos y biopsia; duración ≥ 6 semanas.</p></div>
|
| 105 |
+
</div>
|
| 106 |
+
<!-- Pie Punzante -->
|
| 107 |
+
<div id="pie_punzante" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 108 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-shoe-prints text-blue-700"></i> Osteomielitis Aguda - Pie Punzante</h2>
|
| 109 |
+
<div class="pathogen-list"><span class="pathogen-item">P. aeruginosa</span><span class="pathogen-item">S. aureus</span></div>
|
| 110 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Sin ingreso</div><p class="text-gray-700">Ciprofloxacino 750 mg VO c/12 h x7-14 días.</p></div>
|
| 111 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-hospital text-red-500"></i> Con ingreso</div><p class="text-gray-700">Ceftazidima 2 g IV c/8 h. Si alergia BL: Ciprofloxacino 400 mg IV c/8 h.</p></div>
|
| 112 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Valorar desbridamiento quirúrgico.</p></div>
|
| 113 |
+
</div>
|
| 114 |
+
<!-- Insuficiencia Vascular -->
|
| 115 |
+
<div id="insuf_vascular" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 116 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-hospital text-yellow-600"></i> Osteomielitis - Insuficiencia Vascular</h2>
|
| 117 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Bacilos G(-)</span><span class="pathogen-item">Anaerobios</span></div>
|
| 118 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Sin ingreso</div><p class="text-gray-700">Amox/Clav 875/125 mg VO c/8 h.</p></div>
|
| 119 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-hospital text-red-500"></i> Con ingreso</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV c/6 h. Alergia BL: Aztreonam 2 g IV c/8 h + Metronidazol 500 mg IV c/8 h.</p></div>
|
| 120 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Duración ≥ 6 semanas; multisciplinar: vascular, quirúrgico, descarga.</p></div>
|
| 121 |
+
</div>
|
| 122 |
+
<!-- Osteomielitis Crónica -->
|
| 123 |
+
<div id="osteomielitis_cronica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 124 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-clock text-gray-700"></i> Osteomielitis Crónica</h2>
|
| 125 |
+
<div class="pathogen-list"><span class="pathogen-item">Coag-neg.</span><span class="pathogen-item">Enterococcus</span><span class="pathogen-item">Bacilos G(-)</span></div>
|
| 126 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>No ATB empírico; always dirigir según cultivo.</li><li>Cirugía: desbridamiento, resección de secuestros.</li><li>ATB dirigido, mín. 8 semanas; quinolonas + rifampicina en G(+).</li></ul></div>
|
| 127 |
+
</div>
|
| 128 |
+
<!-- Protésica Precoz -->
|
| 129 |
+
<div id="prot_precoz" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 130 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-blue-400"></i> Infección Protésica - Precoz</h2>
|
| 131 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Coag-neg.</span><span class="pathogen-item">P. aeruginosa</span></div>
|
| 132 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Ceftazidima 2 g IV c/8 h + Daptomicina 8-10 mg/kg IV/24 h.</p></div>
|
| 133 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>Tomar muestra periprotésica (>=5 biopsias).</li><li>Desbridamiento + retención protésica.</li><li>ATB IV 2 sem + VO hasta min. 8 semanas.</li></ul></div>
|
| 134 |
+
</div>
|
| 135 |
+
<!-- Protésica Hematógena -->
|
| 136 |
+
<div id="prot_hematogena" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 137 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-red-400"></i> Infección Protésica - Hematógena</h2>
|
| 138 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Coag-neg.</span><span class="pathogen-item">Bacilos G(-)</span></div>
|
| 139 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Ceftazidima + Daptomicina (mismas dosis).</p></div>
|
| 140 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Hemocultivos + biopsia; desbridamiento y retención.</p></div>
|
| 141 |
+
</div>
|
| 142 |
+
<!-- Protésica Crónica -->
|
| 143 |
+
<div id="prot_cronica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 144 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-calendar-alt text-gray-600"></i> Infección Protésica - Crónica Tardía</h2>
|
| 145 |
+
<div class="pathogen-list"><span class="pathogen-item">Coag-neg.</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Bacilos G(-)</span></div>
|
| 146 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>No ATB empírico; muestras intraoperatorias.</li><li>Recambio protésico en 2 tiempos + ATB IV 1-2 sem + VO hasta 6 semanas.</li></ul></div>
|
| 147 |
+
</div>
|
| 148 |
+
</div>
|
| 149 |
+
<script>
|
| 150 |
+
const sel = document.getElementById('conditionSelector');
|
| 151 |
+
const res = document.getElementById('result');
|
| 152 |
+
const storage = document.getElementById('guide-content-storage');
|
| 153 |
+
sel.addEventListener('change', () => {
|
| 154 |
+
res.innerHTML = '';
|
| 155 |
+
const id = sel.value;
|
| 156 |
+
if (!id) return;
|
| 157 |
+
const node = storage.querySelector('#' + id);
|
| 158 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 159 |
+
});
|
| 160 |
+
</script>
|
| 161 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 162 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 163 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 164 |
+
</div>
|
| 165 |
+
</div>
|
| 166 |
+
</body>
|
| 167 |
+
</html>
|
proa/osteoarticulares_pediatrico.html
ADDED
|
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Osteoarticulares Pediátricas</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-green-800 p-2 rounded-lg text-white"><i class="fas fa-child text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Osteoarticulares Pediátricas</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="episodeSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Grupo de edad/Situación</label>
|
| 33 |
+
<select id="episodeSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-green-800 focus:border-green-800">
|
| 34 |
+
<option value="">-- Selecciona --</option>
|
| 35 |
+
<option value="neonatos"><3 meses</option>
|
| 36 |
+
<option value="tresmeses_cuatroanos">3 meses – 4 años</option>
|
| 37 |
+
<option value="cincoanos_mas">>=5 años</option>
|
| 38 |
+
<option value="postrauma">Postraumatismo (pie)</option>
|
| 39 |
+
<option value="anemia_falciforme">Anemia falciforme</option>
|
| 40 |
+
<option value="alergia_bl">Alergia betalactámicos</option>
|
| 41 |
+
<option value="sus_anaerobios">Sospecha anaerobios</option>
|
| 42 |
+
<option value="sus_sarm">Sospecha SARM</option>
|
| 43 |
+
<option value="trat_oral">Tratamiento oral</option>
|
| 44 |
+
</select>
|
| 45 |
+
</div>
|
| 46 |
+
<div id="result" class="space-y-6"></div>
|
| 47 |
+
<div id="guide-content-storage" class="hidden">
|
| 48 |
+
<div id="neonatos" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 49 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-baby text-blue-800"></i> Neonatos y lactantes (<3 meses)</h2>
|
| 50 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. agalactiae</span><span class="pathogen-item">E. coli</span></div>
|
| 51 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección IV</div><p class="text-gray-700">Cloxacilina 37.5-50 mg/kg IV c/6 h + Cefotaxima 50 mg/kg IV c/6 h.</p></div>
|
| 52 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Cloxacilina + Gentamicina 5-7.5 mg/kg/día IV dosis única.</p></div>
|
| 53 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700"><li>ATB IV 2-4 días en artritis séptica, 5-10 días en osteomielitis.</li><li>Duración total 2-3 semanas (4-6 si osteomielitis aguda o complicaciones).</li></ul></div>
|
| 54 |
+
</div>
|
| 55 |
+
<div id="tresmeses_cuatroanos" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 56 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-child text-green-700"></i> 3 meses – 4 años</h2>
|
| 57 |
+
<div class="pathogen-list"><span class="pathogen-item">Kingella kingae</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. pyogenes</span></div>
|
| 58 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección IV</div><p class="text-gray-700">Cefuroxima 50 mg/kg IV c/8 h.</p></div>
|
| 59 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativas</div><p class="text-gray-700">Cloxacilina + Cefotaxima o Amoxicilina/Clavulánico 25-37.5 mg/kg IV c/6 h.</p></div>
|
| 60 |
+
</div>
|
| 61 |
+
<div id="cincoanos_mas" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 62 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-user-graduate text-indigo-800"></i> >=5 años</h2>
|
| 63 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. pyogenes</span></div>
|
| 64 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección IV</div><p class="text-gray-700">Cloxacilina 37.5-50 mg/kg IV c/6 h.</p></div>
|
| 65 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativas</div><p class="text-gray-700">Cefazolina 100 mg/kg/día IV en 3-4 dosis o Clindamicina 30-40 mg/kg/día IV.</p></div>
|
| 66 |
+
</div>
|
| 67 |
+
<div id="postrauma" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 68 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-shoe-prints text-red-800"></i> Postraumatismo (pie)</h2>
|
| 69 |
+
<div class="pathogen-list"><span class="pathogen-item">P. aeruginosa</span><span class="pathogen-item">S. aureus</span></div>
|
| 70 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección IV</div><p class="text-gray-700">Cloxacilina 37.5-50 mg/kg IV c/6 h + Ceftazidima 50 mg/kg IV c/8 h.</p></div>
|
| 71 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Levofloxacino >6 m-5 a: 8-10 mg/kg c/12 h; >5 a: 10 mg/kg c/24 h IV.</p></div>
|
| 72 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><p class="text-gray-700">Factor de riesgo Pseudomonas y S. aureus.</p></div>
|
| 73 |
+
</div>
|
| 74 |
+
<div id="anemia_falciforme" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 75 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tint text-blue-900"></i> Anemia de células falciformes</h2>
|
| 76 |
+
<div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Salmonella</span><span class="pathogen-item">E. coli</span></div>
|
| 77 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Elección IV</div><p class="text-gray-700">Cloxacilina 37.5-50 mg/kg IV c/6 h + Cefotaxima 50 mg/kg IV c/6 h.</p></div>
|
| 78 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Amoxicilina/Clavulánico 25-37.5 mg/kg IV c/6 h.</p></div>
|
| 79 |
+
</div>
|
| 80 |
+
<div id="alergia_bl" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 81 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-allergies text-orange-600"></i> Alergia a betalactámicos</h2>
|
| 82 |
+
<div class="pathogen-list"><span class="pathogen-item">Varía según patología</span></div>
|
| 83 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Clindamicina 30-40 mg/kg/día IV en 3-4 dosis.</p></div>
|
| 84 |
+
</div>
|
| 85 |
+
<div id="sus_anaerobios" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 86 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bacterium text-purple-600"></i> Sospecha de anaerobios</h2>
|
| 87 |
+
<div class="pathogen-list"><span class="pathogen-item">Anaerobios mixtos</span></div>
|
| 88 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Opciones IV</div><p class="text-gray-700">Clindamicina 30-40 mg/kg/día o Amoxicilina/Clavulánico 25-37.5 mg/kg c/6 h o Metronidazol 20-30 mg/kg/día IV.</p></div>
|
| 89 |
+
</div>
|
| 90 |
+
<div id="sus_sarm" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 91 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-skull-crossbones text-red-800"></i> Sospecha de SARM</h2>
|
| 92 |
+
<div class="pathogen-list"><span class="pathogen-item">SARM</span></div>
|
| 93 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p class="text-gray-700">Vancomicina 40-60 mg/kg/día en 3-4 dosis o Linezolid 10 mg/kg c/8 h ± Rifampicina o Daptomicina.</p></div>
|
| 94 |
+
</div>
|
| 95 |
+
<div id="trat_oral" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 96 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-pills text-green-500"></i> Tratamiento Antimicrobiano Oral</h2>
|
| 97 |
+
<div class="pathogen-list"><span class="pathogen-item">Cultivos negativos</span></div>
|
| 98 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> Menores de 5 años</div><p class="text-gray-700">Cefuroxima-axetilo 30 mg/kg VO c/8 h.</p></div>
|
| 99 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Mayores de 5 años</div><p class="text-gray-700">Cefadroxilo 30 mg/kg VO c/8 h.</p></div>
|
| 100 |
+
</div>
|
| 101 |
+
</div>
|
| 102 |
+
<script>
|
| 103 |
+
const sel = document.getElementById('episodeSelector');
|
| 104 |
+
const res = document.getElementById('result');
|
| 105 |
+
const storage = document.getElementById('guide-content-storage');
|
| 106 |
+
sel.addEventListener('change', () => {
|
| 107 |
+
res.innerHTML = '';
|
| 108 |
+
const id = sel.value;
|
| 109 |
+
if (!id) return;
|
| 110 |
+
const node = storage.querySelector('#' + id);
|
| 111 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 112 |
+
});
|
| 113 |
+
</script>
|
| 114 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 115 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 116 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 117 |
+
</div>
|
| 118 |
+
</div>
|
| 119 |
+
</body>
|
| 120 |
+
</html>
|
proa/piel_partes_blandas.html
ADDED
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Piel y Partes Blandas</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-cut text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Piel y Partes Blandas</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Diagnóstico</label>
|
| 33 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 34 |
+
<option value="">-- Selecciona un diagnóstico --</option>
|
| 35 |
+
<option value="absceso_cutaneo">Absceso Cutáneo</option>
|
| 36 |
+
<option value="erisipela_celulitis">Erisipela/Celulitis/Linfangitis</option>
|
| 37 |
+
<option value="celulitis_especiales">Celulitis Contextos Específicos</option>
|
| 38 |
+
<option value="mordeduras">Mordeduras</option>
|
| 39 |
+
<option value="impetigo">Impétigo</option>
|
| 40 |
+
<option value="infecciones_profundas">Infecciones Profundas/Necrotizantes</option>
|
| 41 |
+
<option value="pie_diabetico">Pie Diabético</option>
|
| 42 |
+
<option value="ulceras_presion">Úlceras por Presión</option>
|
| 43 |
+
<option value="herpes_zoster">Herpes Zoster</option>
|
| 44 |
+
</select>
|
| 45 |
+
</div>
|
| 46 |
+
<div id="result" class="space-y-6"></div>
|
| 47 |
+
|
| 48 |
+
<div id="guide-content-storage" class="hidden">
|
| 49 |
+
<!-- Absceso Cutáneo -->
|
| 50 |
+
<div id="absceso_cutaneo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 51 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-cut text-red-500"></i> Absceso Cutáneo</h2>
|
| 52 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Otros (según exposición/localización)</span></div></div>
|
| 53 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico (si indicado¹)</h3>
|
| 54 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Cefalexina 0.5-1 g VO cada 8h durante 5 días.</p></div>
|
| 55 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5 días.</p></div>
|
| 56 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-map-marker-alt text-purple-500"></i> Caso específico: Absceso Perianal/Perirectal²</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5-7 días.<br><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span><br> Ciprofloxacino 500-750 mg VO cada 12h + Metronidazol 500 mg VO cada 8h durante 5 días.</p></div>
|
| 57 |
+
</div>
|
| 58 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div><ul class="list-disc text-gray-700 space-y-1"><li>Muchos abscesos cutáneos precisan solo <strong>drenaje</strong>.</li><li>¹Indicación de antibioterapia:<ul><li>Fiebre u otros signos sistémicos de infección.</li><li>Tamaño ≥ 5 cm.</li><li>Celulitis significativa alrededor del absceso.</li><li>Múltiples localizaciones o localizaciones complicadas (cara, mano, genitales).</li><li>Portador de material protésico osteoarticular o cardiovascular.</li><li>Valvulopatía cardíaca significativa.</li><li>Pacientes inmunodeprimidos.</li></ul></li><li>²Si absceso perianal/perirectal, avisar a Cirugía.</li></ul></div>
|
| 59 |
+
</div>
|
| 60 |
+
<!-- Erisipela/Celulitis -->
|
| 61 |
+
<div id="erisipela_celulitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 62 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bacterium text-red-500"></i> Erisipela, Celulitis y Linfangitis (Inicio Comunitario)</h2>
|
| 63 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">S. pyogenes</span><span class="pathogen-item">Estreptococos Grupo B, C, G</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Bacilos Gramnegativos (en inmunodeprimidos/hepatópatas)</span></div></div>
|
| 64 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3>
|
| 65 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-dot-circle text-pink-500"></i> Erisipela</div><p class="text-gray-700"><strong>De elección:</strong> Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 300-600 mg VO cada 8h durante 5-10 días.</p></div>
|
| 66 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-dot-circle text-red-500"></i> Celulitis, Linfangitis o Duda (Erisipela vs Celulitis)</div><p class="text-gray-700"><strong>De elección:</strong> Cefalexina 0.5-1 g VO cada 6-8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 300-600 mg VO cada 8h durante 5-10 días.</p></div>
|
| 67 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-procedures text-red-700"></i> Si Criterios de Ingreso</div><p class="text-gray-700"><strong>De elección:</strong> Cefazolina 2 g IV cada 8h durante 7-10 días.</p></div>
|
| 68 |
+
</div>
|
| 69 |
+
</div>
|
| 70 |
+
<!-- Celulitis Específica -->
|
| 71 |
+
<div id="celulitis_especiales" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 72 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tint text-cyan-500"></i> Celulitis en Contextos Específicos</h2>
|
| 73 |
+
<div class="treatment-option border-cyan-500"><div class="treatment-title"><i class="fas fa-water text-cyan-600"></i> Celulitis asociada al Agua y Medio Acuático</div><h4 class="font-semibold text-gray-600 mb-1">Agentes etiológicos:</h4><div class="pathogen-list mb-2"><span class="pathogen-item">Vibrio vulnificus (agua salada)</span><span class="pathogen-item">P. aeruginosa</span></div><p class="text-gray-700"><strong>De elección:</strong> Ciprofloxacino 750 mg VO cada 12h durante 5-7 días.</p></div>
|
| 74 |
+
<div class="treatment-option border-gray-500"><div class="treatment-title"><i class="fas fa-shoe-prints text-gray-600"></i> Celulitis asociada a Punción de Pie</div><h4 class="font-semibold text-gray-600 mb-1">Agente etiológico:</h4><div class="pathogen-list mb-2"><span class="pathogen-item">P. aeruginosa</span></div><p class="text-gray-700"><strong>De elección:</strong> Ciprofloxacino 750 mg VO cada 12h durante 5-7 días.</p></div>
|
| 75 |
+
<div class="treatment-option border-pink-500"><div class="treatment-title"><i class="fas fa-fish text-pink-600"></i> Celulitis asociada a Manejo de Carne o Pescado</div><h4 class="font-semibold text-gray-600 mb-1">Agente etiológico:</h4><div class="pathogen-list mb-2"><span class="pathogen-item">Erysipelothrix rhusiopathiae</span></div><p class="text-gray-700"><strong>De elección:</strong> Amoxicilina 1 g VO cada 8h ó Ciprofloxacino 500 mg VO cada 12h durante 5-7 días.</p></div>
|
| 76 |
+
</div>
|
| 77 |
+
<!-- Mordeduras -->
|
| 78 |
+
<div id="mordeduras" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 79 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-gray-700"></i> Infección asociada a Mordedura</h2>
|
| 80 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Polimicrobianas</span><span class="pathogen-item">Gato: P. multocida</span><span class="pathogen-item">Perro: P. multocida, Capnocytophaga</span><span class="pathogen-item">Humano: Eikenella corrodens</span></div></div>
|
| 81 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento / profilaxis</h3>
|
| 82 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento/Profilaxis de elección</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h.</p></div>
|
| 83 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Cotrimoxazol 800/160 mg/12h VO ó Doxiciclina 100 mg/12h VO + Clindamicina 450-600 mg/8h VO ó Metronidazol 500 mg/8h VO.</p></div>
|
| 84 |
+
</div>
|
| 85 |
+
</div>
|
| 86 |
+
<!-- Impétigo -->
|
| 87 |
+
<div id="impetigo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 88 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-child text-yellow-600"></i> Impétigo</h2>
|
| 89 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. pyogenes (Grupo A)</span></div></div>
|
| 90 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3>
|
| 91 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección (tópico)</div><p class="text-gray-700">Ácido fusídico ó Mupirocina tópica cada 8h durante 5-7 días.</p></div>
|
| 92 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Tratamiento sistémico (casos extensos)</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5-10 días.</p></div>
|
| 93 |
+
</div>
|
| 94 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-stethoscope text-yellow-500"></i> Observaciones</div><p class="text-gray-700">El diagnóstico suele ser clínico.</p></div>
|
| 95 |
+
</div>
|
| 96 |
+
<!-- Infecciones Profundas -->
|
| 97 |
+
<div id="infecciones_profundas" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 98 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-skull-crossbones text-black"></i> Infecciones Profundas y/o Necrotizantes</h2>
|
| 99 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Estreptococos Grupo A o B</span><span class="pathogen-item">Clostridium</span><span class="pathogen-item">S. aureus</span></div></div>
|
| 100 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3>
|
| 101 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV cada 6h + Clindamicina 600-900 mg IV cada 8h.</p></div>
|
| 102 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Vancomicina 25 mg/kg IV + Aztreonam 2 g IV cada 8h + Clindamicina 600 mg IV cada 8h.</p></div>
|
| 103 |
+
</div>
|
| 104 |
+
</div>
|
| 105 |
+
<!-- Pie Diabético -->
|
| 106 |
+
<div id="pie_diabetico" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 107 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-shoe-prints text-red-600"></i> Infección de Pie Diabético</h2>
|
| 108 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><p class="text-gray-600 text-sm mb-2">Varían según gravedad y tratamientos previos:</p><div class="pathogen-list"><span class="pathogen-item">Gram positivos (Leve)</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. agalactiae</span><span class="pathogen-item">S. pyogenes</span><span class="pathogen-item">Polimicrobianas (Grave)</span><span class="pathogen-item">Enterobacterias</span><span class="pathogen-item">P. aeruginosa</span><span class="pathogen-item">Bacteroides spp</span><span class="pathogen-item">Clostridium</span></div></div>
|
| 109 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 110 |
+
<div class="treatment-option border-green-500"><div class="treatment-title"><i class="fas fa-thermometer-empty text-green-600"></i> Pie Diabético - Leve</div><p class="text-gray-700">Cefalexina 0.5-1 g VO cada 6-8h por 5-10 días.</p></div>
|
| 111 |
+
<div class="treatment-option border-yellow-500"><div class="treatment-title"><i class="fas fa-thermometer-half text-yellow-600"></i> Pie Diabético - Moderada</div><p class="text-gray-700">Cefazolina 2 g IV cada 6-8h por 7-10 días.</p></div>
|
| 112 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-thermometer-full text-red-600"></i> Pie Diabético - Grave</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV c/6h + Clindamicina 600-900 mg IV c/8h.</p></div>
|
| 113 |
+
</div>
|
| 114 |
+
</div>
|
| 115 |
+
<!-- Úlceras por Presión -->
|
| 116 |
+
<div id="ulceras_presion" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 117 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bed text-blue-700"></i> Infección de Úlceras por Presión (UPP)</h2>
|
| 118 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span></div></div>
|
| 119 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3>
|
| 120 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-procedures text-red-600"></i> Infección Profunda</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV c/6h + Vancomicina 20 mg/kg IV (dosis inicial) seguido 15 mg/kg/12h.</p></div>
|
| 121 |
+
</div>
|
| 122 |
+
</div>
|
| 123 |
+
<!-- Herpes Zoster -->
|
| 124 |
+
<div id="herpes_zoster" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 125 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-virus text-purple-600"></i> Herpes Zoster</h2>
|
| 126 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agente etiológico</h3><div class="pathogen-list"><span class="pathogen-item">Virus Varicela-Zoster</span></div></div>
|
| 127 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3>
|
| 128 |
+
<div class="treatment-option border-green-500"><div class="treatment-title"><i class="fas fa-user text-green-600"></i> Leve/Immunocompetentes</div><p class="text-gray-700">Aciclovir 800 mg VO 5 veces/día por 7 días.</p></div>
|
| 129 |
+
<div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-user-shield text-red-600"></i> Grave/Inmunodeprimidos</div><p class="text-gray-700">Aciclovir 10 mg/kg IV c/8h por 7 días.</p></div>
|
| 130 |
+
</div>
|
| 131 |
+
</div>
|
| 132 |
+
</div>
|
| 133 |
+
|
| 134 |
+
<script>
|
| 135 |
+
const sel = document.getElementById('diagnosticSelector');
|
| 136 |
+
const res = document.getElementById('result');
|
| 137 |
+
const storage = document.getElementById('guide-content-storage');
|
| 138 |
+
sel.addEventListener('change', () => {
|
| 139 |
+
res.innerHTML = '';
|
| 140 |
+
const id = sel.value;
|
| 141 |
+
if (!id) return;
|
| 142 |
+
const node = storage.querySelector('#' + id);
|
| 143 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 144 |
+
});
|
| 145 |
+
</script>
|
| 146 |
+
|
| 147 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 148 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 149 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 150 |
+
</div>
|
| 151 |
+
</div>
|
| 152 |
+
</body>
|
| 153 |
+
</html>
|
proa/proa.html
ADDED
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Tratamientos Empíricos (Integrada V2)</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body {
|
| 12 |
+
font-family: 'Montserrat', sans-serif;
|
| 13 |
+
background-color: #f8fafc; /* bg-gray-50 */
|
| 14 |
+
}
|
| 15 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 16 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0, 0, 0, 0.1), 0 4px 6px -2px rgba(0, 0, 0, 0.05); }
|
| 17 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 18 |
+
.pathogen-item { background-color: #e0f2fe; /* bg-sky-100 */ color: #0369a1; /* text-sky-800 */ padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 19 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; /* border-blue-500 */ }
|
| 20 |
+
.treatment-title { font-weight: 600; color: #1e40af; /* text-blue-800 */ margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 21 |
+
.note-box { background-color: #fffbeb; /* bg-amber-50 */ border-left: 4px solid #f59e0b; /* border-amber-500 */ padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 22 |
+
.note-title { font-weight: 600; color: #92400e; /* text-amber-800 */ display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 23 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; -webkit-print-color-adjust: exact; print-color-adjust: exact; }
|
| 24 |
+
ul { list-style-position: outside; margin-left: 1.25rem; /* Equivalente a pl-5 de Tailwind */ }
|
| 25 |
+
li { margin-bottom: 0.25rem; /* Espaciado entre elementos de lista */ }
|
| 26 |
+
.sub-selector-container { display: grid; grid-template-columns: 1fr; } /* Contenedor para sub-selectores */
|
| 27 |
+
@media (min-width: 768px) { /* md breakpoint */
|
| 28 |
+
.sub-selector-container { grid-template-columns: repeat(3, 1fr); /* Tres columnas en desktop */ }
|
| 29 |
+
}
|
| 30 |
+
</style>
|
| 31 |
+
</head>
|
| 32 |
+
<body class="min-h-screen bg-gray-50">
|
| 33 |
+
<div class="max-w-6xl mx-auto px-4 py-8">
|
| 34 |
+
<div class="flex flex-col md:flex-row justify-between items-start md:items-center mb-8 gap-4">
|
| 35 |
+
<div>
|
| 36 |
+
<div class="flex items-center gap-3 mb-2">
|
| 37 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-book-medical text-2xl"></i></div>
|
| 38 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Tratamientos Empíricos (Integrada V2)</h1>
|
| 39 |
+
</div>
|
| 40 |
+
<p class="text-gray-600">Selección de protocolos terapéuticos basados en evidencia</p>
|
| 41 |
+
</div>
|
| 42 |
+
<div class="bg-blue-50 px-4 py-2 rounded-lg border border-blue-100 flex items-center gap-2">
|
| 43 |
+
<i class="fas fa-info-circle text-blue-500"></i>
|
| 44 |
+
<span class="text-sm text-blue-700">Versión: Abr 2025 (Integrada)</span>
|
| 45 |
+
</div>
|
| 46 |
+
</div>
|
| 47 |
+
|
| 48 |
+
<div class="bg-white rounded-xl shadow-md overflow-hidden">
|
| 49 |
+
<div class="p-6 border-b border-gray-200">
|
| 50 |
+
<h2 class="text-xl font-semibold text-gray-800 mb-4 flex items-center gap-2">
|
| 51 |
+
<i class="fas fa-search text-blue-500"></i>
|
| 52 |
+
Seleccione la categoría y guía a consultar
|
| 53 |
+
</h2>
|
| 54 |
+
<div class="grid grid-cols-1 md:grid-cols-2 gap-6 mb-6">
|
| 55 |
+
<div>
|
| 56 |
+
<label for="mainGuideSelector" class="block text-sm font-medium text-gray-700 mb-1">
|
| 57 |
+
<i class="fas fa-layer-group text-gray-500 mr-1"></i>
|
| 58 |
+
Categoría principal
|
| 59 |
+
</label>
|
| 60 |
+
<select id="mainGuideSelector" class="custom-select mt-1 block w-full pl-3 pr-10 py-2 text-base border border-gray-300 focus:outline-none focus:ring-blue-500 focus:border-blue-500 sm:text-sm rounded-md">
|
| 61 |
+
<option value="">-- Seleccione una guía --</option>
|
| 62 |
+
<option value="bacteremia_cateter">Bacteremia Asociada a Catéter</option>
|
| 63 |
+
<option value="digestivo">Digestivo</option>
|
| 64 |
+
<option value="digestivo_ped">Digestivo PED</option>
|
| 65 |
+
<option value="endocarditis_infecciosa">Endocarditis infecciosa</option>
|
| 66 |
+
<option value="embarazadas">Embarazadas</option>
|
| 67 |
+
<option value="ginecologicas">Ginecología</option>
|
| 68 |
+
<option value="neutropenia">Neutropénia</option>
|
| 69 |
+
<option value="oftalmologia">Oftalmologia</option>
|
| 70 |
+
<option value="orl">ORL</option> <option value="orl_ped">ORL PED</option>
|
| 71 |
+
<option value="osteoarticular">Osteoarticular</option>
|
| 72 |
+
<option value="osteoarticulares_ped">Osteoarticulares PED</option>
|
| 73 |
+
<option value="piel_partes_blandas">Piel y partes blandas</option> <option value="respiratorio">Respiratorio</option>
|
| 74 |
+
<option value="respiratorias_ped">Respiratorias PED</option>
|
| 75 |
+
<option value="sistema_nervioso_central_ped">Sistema Nervioso Central PED</option>
|
| 76 |
+
<option value="sindrome_febril_ped">Síndrome febril agudo sin foco PED</option>
|
| 77 |
+
<option value="infecciones_tracto_urinario_adultos">Urología</option> <option value="urologia_ped">Urología PED</option>
|
| 78 |
+
</select>
|
| 79 |
+
</div>
|
| 80 |
+
</div>
|
| 81 |
+
<div id="subSelectorsContainer" class="grid grid-cols-1 md:grid-cols-3 gap-6">
|
| 82 |
+
<div id="utiSubSelectorDiv" class="hidden">
|
| 83 |
+
<label for="utiSelector" class="block text-sm font-medium text-gray-700 mb-1">
|
| 84 |
+
<i class="fas fa-arrow-down text-blue-500 mr-1"></i>
|
| 85 |
+
Diagnóstico (Urología)
|
| 86 |
+
</label>
|
| 87 |
+
<select id="utiSelector" class="custom-select mt-1 block w-full pl-3 pr-10 py-2 text-base border border-gray-300 focus:outline-none focus:ring-blue-500 focus:border-blue-500 sm:text-sm rounded-md">
|
| 88 |
+
<option value="">-- Seleccione diagnóstico --</option>
|
| 89 |
+
<option value="bacteriuria_asintomatica">Bacteriuria asintomática</option>
|
| 90 |
+
<option value="cistitis_simple">Cistitis simple (no complicada)</option>
|
| 91 |
+
<option value="cistitis_complicada">Cistitis complicada</option>
|
| 92 |
+
<option value="pielonefritis_aguda">Pielonefritis aguda</option>
|
| 93 |
+
<option value="prostatitis_aguda">Prostatitis aguda</option>
|
| 94 |
+
<option value="prostatitis_ingreso">Prostatitis aguda (ingreso)</option>
|
| 95 |
+
<option value="prostatitis_cronica">Prostatitis crónica</option>
|
| 96 |
+
<option value="orquiepididimitis">Orquiepididimitis</option>
|
| 97 |
+
<option value="infecciones_sondado">Paciente sondado</option>
|
| 98 |
+
</select>
|
| 99 |
+
</div>
|
| 100 |
+
<div id="ppbSubSelectorDiv" class="hidden">
|
| 101 |
+
<label for="ppbSelector" class="block text-sm font-medium text-gray-700 mb-1">
|
| 102 |
+
<i class="fas fa-arrow-down text-red-500 mr-1"></i>
|
| 103 |
+
Diagnóstico (Piel/PB)
|
| 104 |
+
</label>
|
| 105 |
+
<select id="ppbSelector" class="custom-select mt-1 block w-full pl-3 pr-10 py-2 text-base border border-gray-300 focus:outline-none focus:ring-red-500 focus:border-red-500 sm:text-sm rounded-md">
|
| 106 |
+
<option value="">-- Seleccione diagnóstico --</option>
|
| 107 |
+
<option value="absceso_cutaneo">Absceso Cutáneo</option>
|
| 108 |
+
<option value="erisipela_celulitis">Erisipela/Celulitis/Linfangitis</option>
|
| 109 |
+
<option value="celulitis_especiales">Celulitis (Contextos Específicos)</option>
|
| 110 |
+
<option value="mordeduras">Mordeduras</option>
|
| 111 |
+
<option value="impetigo">Impétigo</option>
|
| 112 |
+
<option value="infecciones_profundas">Inf. Profundas/Necrotizantes</option>
|
| 113 |
+
<option value="pie_diabetico">Pie Diabético</option>
|
| 114 |
+
<option value="ulceras_presion">Úlceras por Presión</option>
|
| 115 |
+
<option value="herpes_zoster">Herpes Zoster</option>
|
| 116 |
+
</select>
|
| 117 |
+
</div>
|
| 118 |
+
<div id="orlSubSelectorDiv" class="hidden">
|
| 119 |
+
<label for="orlSelector" class="block text-sm font-medium text-gray-700 mb-1">
|
| 120 |
+
<i class="fas fa-arrow-down text-purple-500 mr-1"></i>
|
| 121 |
+
Diagnóstico (ORL)
|
| 122 |
+
</label>
|
| 123 |
+
<select id="orlSelector" class="custom-select mt-1 block w-full pl-3 pr-10 py-2 text-base border border-gray-300 focus:outline-none focus:ring-purple-500 focus:border-purple-500 sm:text-sm rounded-md">
|
| 124 |
+
<option value="">-- Seleccione diagnóstico --</option>
|
| 125 |
+
<option value="otitis_media_aguda">Otitis Media Aguda</option>
|
| 126 |
+
<option value="otitis_externa">Otitis Externa</option>
|
| 127 |
+
<option value="faringoamigdalitis">Faringoamigdalitis</option>
|
| 128 |
+
<option value="rinosinusitis_aguda">Rinosinusitis Aguda</option>
|
| 129 |
+
<option value="otomastoiditis">Otomastoiditis</option>
|
| 130 |
+
<option value="candidiasis_oral">Candidiasis Oral</option>
|
| 131 |
+
<option value="gingivoestomatitis_herpetica">Gingivoestomatitis Herpética</option>
|
| 132 |
+
<option value="herpes_labial">Herpes Labial</option>
|
| 133 |
+
<option value="infeccion_odontogenica_no_ingreso">Inf. Odontogénica (no ingreso)</option>
|
| 134 |
+
<option value="infeccion_odontogenica_ingreso">Inf. Odontogénica (ingreso)</option>
|
| 135 |
+
<option value="sialoadenitis_supurada">Sialoadenitis Aguda Supurada</option>
|
| 136 |
+
<option value="fascitis_necrotizante">Fascitis Necrotizante Cervicofacial</option>
|
| 137 |
+
</select>
|
| 138 |
+
</div>
|
| 139 |
+
</div>
|
| 140 |
+
</div>
|
| 141 |
+
|
| 142 |
+
<div id="result" class="p-6">
|
| 143 |
+
</div>
|
| 144 |
+
</div>
|
| 145 |
+
|
| 146 |
+
<div class="mt-8 text-center text-sm text-gray-500">
|
| 147 |
+
<p>© 2025 Comité de PROA - Todos los derechos reservados</p>
|
| 148 |
+
<p class="mt-1">Para uso exclusivo del personal médico</p>
|
| 149 |
+
</div>
|
| 150 |
+
|
| 151 |
+
</div>
|
| 152 |
+
|
| 153 |
+
<div id="guide-content-storage" style="display: none;">
|
| 154 |
+
|
| 155 |
+
<div id="content-infecciones_tracto_urinario_adultos">
|
| 156 |
+
<div class="space-y-8">
|
| 157 |
+
<div id="bacteriuria_asintomatica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 158 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-urinal text-blue-500"></i> Bacteriuria Asintomática</h2>
|
| 159 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><p class="text-gray-700">Cualquier microorganismo, siendo <strong>E. coli</strong> el más frecuente.</p></div>
|
| 160 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div><ul class="list-disc pl-5 text-gray-700 space-y-1"><li>No se indica tratamiento en pacientes asintomáticos, salvo en embarazo o antes de procedimientos con riesgo de sangrado.</li></ul></div>
|
| 161 |
+
</div>
|
| 162 |
+
<div id="cistitis_simple" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 163 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bladder text-blue-500"></i> Cistitis Simple (no complicada)</h2>
|
| 164 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Otras enterobacterias (>80%)</span><span class="pathogen-item">E. faecalis</span><span class="pathogen-item">Proteus spp</span><span class="pathogen-item">Staphylococcus saprophyticus</span></div></div>
|
| 165 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Fosfomicina trometamol 3 g VO, dosis única en toma nocturna.<br> Puede repetirse a las 48–72 h si persisten los síntomas.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Cefuroxima 250–500 mg VO cada 12 h durante 5 días.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Nitrofurantoína 100 mg VO cada 8 h durante 5 días.</p></div></div>
|
| 166 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div><ul class="list-disc pl-5 text-gray-700 space-y-1"><li>En cistitis no complicadas y no recidivantes, no se indica urocultivo de rutina.</li><li>Se recomienda urocultivo en caso de sospecha de pielonefritis, síntomas persistentes o recurrencia entre 2–4 semanas, o en mujeres con síntomas atípicos.</li><li>Quinolonas y TMT/SMX tienen resistencia aproximada del 20% y no se usan en tratamiento empírico.</li><li>Nitrofurantoína está contraindicada si Clcreat <50 ml/min, en tratamientos >7 días y en el primer trimestre del embarazo.</li></ul></div>
|
| 167 |
+
</div>
|
| 168 |
+
<div id="cistitis_complicada" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 169 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bladder text-blue-500"></i> Cistitis Complicada</h2>
|
| 170 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Otras enterobacterias (>80%)</span><span class="pathogen-item">E. faecalis</span><span class="pathogen-item">Proteus spp</span><span class="pathogen-item">Staphylococcus saprophyticus</span></div></div>
|
| 171 |
+
<div class="note-box"><p class="font-medium text-gray-700">Observaciones:</p><ul class="list-disc pl-5 text-gray-600"><li>Realizar urocultivo pretratamiento y ajustar según antibiograma.</li><li>La duración del tratamiento debe ser de 7 días.</li></ul></div>
|
| 172 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Fosfomicina trometamol 3 g VO, repetir a las 48–72 h.<br> Mantener tratamiento durante 7 días.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativas</div><p class="text-gray-700">Pautas similares a la cistitis simple, con tratamiento de 7 días:<br> - Cefuroxima 500 mg/12 h VO<br> - Cefixima 400 mg/24 h VO</p></div></div>
|
| 173 |
+
</div>
|
| 174 |
+
<div id="pielonefritis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 175 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-kidneys text-blue-500"></i> Pielonefritis Aguda</h2>
|
| 176 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Otras enterobacterias (>80%)</span><span class="pathogen-item">Staphylococcus saprophyticus</span></div></div>
|
| 177 |
+
<div class="note-box"><p class="font-medium text-gray-700">Observaciones iniciales:</p><ul class="list-disc pl-5 text-gray-600"><li>Realizar urocultivo antes del inicio del tratamiento.</li><li>En casos graves, considerar inicio parenteral.</li></ul></div>
|
| 178 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><ul class="list-disc pl-5 text-gray-700"><li>Cefuroxima 500 mg/12 h VO</li><li>Cefixima 200 mg/12 h VO o 400 mg/24 h VO</li></ul><p class="text-sm text-gray-500 mt-2">Duración: 7 días</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-syringe text-blue-500"></i> Inicio parenteral (opcional)</div><p class="text-gray-700">Ceftriaxona 2 g IV/IM dosis única</p><p class="text-sm text-gray-500 mt-1">En algunos casos, puede asociarse Tobramicina 200 mg IV/IM</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Tobramicina 200 mg IM/24 h durante 5 días</p></div></div>
|
| 179 |
+
</div>
|
| 180 |
+
<div id="prostatitis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 181 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-mars text-blue-500"></i> Prostatitis Aguda</h2>
|
| 182 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">E. coli (más común)</span><span class="pathogen-item">Proteus spp</span><span class="pathogen-item">Klebsiella spp</span><span class="pathogen-item">Pseudomonas aeruginosa</span><span class="pathogen-item">Enterococcus faecalis</span></div><p class="text-sm text-gray-500 mt-2">En pacientes sexualmente activos, considerar ETS (N. gonorrhoeae, Chlamydia).</p></div>
|
| 183 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><ul class="list-disc pl-5 text-gray-700"><li>Cefuroxima 500 mg/12 h VO</li><li>Cefixima 200 mg/12 h VO</li></ul><p class="text-sm text-gray-500 mt-2">Puede iniciarse con dosis parenteral única: Ceftriaxona 2 g IV/IM o Tobramicina/Gentamicina 5–7 mg/kg/24 h.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Tobramicina 5 mg/kg IV/IM (dosis única) seguida de:</p><ul class="list-disc pl-5 text-gray-600"><li>Ciprofloxacino 750 mg/12 h VO</li><li>Trimetroprim/Sulfametoxazol</li></ul></div></div>
|
| 184 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-clock text-yellow-500"></i> Observaciones</div><p class="text-gray-700">El tratamiento debe mantenerse durante 14–21 días en prostatitis aguda.</p></div>
|
| 185 |
+
</div>
|
| 186 |
+
<div id="prostatitis_ingreso" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 187 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-procedures text-red-500"></i> Prostatitis Aguda (con criterios de ingreso)</h2>
|
| 188 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Proteus spp</span><span class="pathogen-item">Klebsiella spp</span><span class="pathogen-item">Pseudomonas aeruginosa</span><span class="pathogen-item">Enterococcus spp</span></div></div>
|
| 189 |
+
<div class="note-box"><p class="font-medium text-gray-700">Observaciones iniciales:</p><ul class="list-disc pl-5 text-gray-600"><li>Solicitar urocultivo y hemocultivos.</li><li>Evaluación por urología y monitorización estrecha.</li></ul></div>
|
| 190 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Ceftriaxona 2 g/24 h IV. En casos graves, puede asociarse a aminoglucósido.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Aztreonam 1–2 g/8 h IV + Amikacina 15 mg/kg/24 h IV</p></div></div>
|
| 191 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-clipboard-check text-yellow-500"></i> Seguimiento</div><ul class="list-disc pl-5 text-gray-700"><li>Reevaluar a las 72 h.</li><li>Realizar pruebas de imagen (ecografía, TAC) si no hay mejoría.</li><li>Repetir cultivos si persiste la fiebre.</li></ul></div>
|
| 192 |
+
</div>
|
| 193 |
+
<div id="prostatitis_cronica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 194 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-history text-blue-500"></i> Prostatitis Crónica</h2>
|
| 195 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos (forma bacteriana)</h3><div class="pathogen-list"><span class="pathogen-item">Enterobacterias (E. coli)</span><span class="pathogen-item">Pseudomonas aeruginosa</span><span class="pathogen-item">Enterococcus spp</span><span class="pathogen-item">Staphylococcus aureus</span></div></div>
|
| 196 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Opciones frecuentes (según antibiograma)</div><ul class="list-disc pl-5 text-gray-700"><li>Fluoroquinolonas (Ciprofloxacino, Levofloxacino)</li><li>Trimetroprim-Sulfametoxazol</li><li>Doxiciclina (en casos seleccionados)</li></ul><p class="text-sm text-gray-500 mt-2">Duración: Generalmente 4-6 semanas.</p></div></div>
|
| 197 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Importante</div><p class="text-gray-700">El diagnóstico y manejo de la prostatitis crónica puede ser complejo y requiere evaluación urológica detallada.</p></div>
|
| 198 |
+
</div>
|
| 199 |
+
<div id="orquiepididimitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 200 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-male text-blue-500"></i> Orquiepididimitis</h2>
|
| 201 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">Chlamydia trachomatis (<35 años)</span><span class="pathogen-item">Neisseria gonorrhoeae (<35 años)</span><span class="pathogen-item">Patógenos urinarios (E. coli, etc. en >35 años o prácticas de riesgo)</span></div></div>
|
| 202 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-venus-mars text-green-500"></i> Sospecha ETS (<35 años o riesgo)</div><ul class="list-disc pl-5 text-gray-700"><li>Ceftriaxona 1 g IM dosis única +</li><li>Doxiciclina 100 mg/12 h VO durante 10 días</li></ul></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-bacteria text-blue-500"></i> Sospecha Enterobacterias (>35 años, bajo riesgo ETS)</div><ul class="list-disc pl-5 text-gray-700"><li>Levofloxacino 500 mg/24 h VO durante 10 días</li><li>Ofloxacino 300 mg/12 h VO durante 10 días</li></ul><p class="text-sm text-gray-500 mt-2">Considerar ajustar según urocultivo si se realiza.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia Beta-lactámicos (en caso ETS)</div><p class="text-gray-700">Consultar guías específicas de ETS o especialista. Azitromicina puede ser una opción pero evaluar resistencias.</p></div></div>
|
| 203 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-users text-yellow-500"></i> Observaciones</div><ul class="list-disc pl-5 text-gray-700"><li>Se debe tratar a la pareja sexual si se confirma ETS.</li><li>Reposo, elevación escrotal y analgésicos (AINEs) son cruciales.</li><li>Seguimiento clínico a los 3–7 días para evaluar respuesta.</li><li>Descartar torsión testicular (urgencia quirúrgica).</li></ul></div>
|
| 204 |
+
</div>
|
| 205 |
+
<div id="infecciones_sondado" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 206 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-catheter text-blue-500"></i> Infecciones en Paciente Sondado (Sintomático)</h2>
|
| 207 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-info-circle text-blue-500"></i> Consideraciones Clave</h3><p class="text-gray-700">La bacteriuria asintomática en paciente sondado <strong>NO</strong> se trata habitualmente. Tratar sólo si hay <strong>síntomas</strong> de infección (fiebre, dolor suprapúbico, afectación sistémica).</p></div>
|
| 208 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos</h3><div class="pathogen-list"><span class="pathogen-item">E. coli</span><span class="pathogen-item">Klebsiella spp</span><span class="pathogen-item">Proteus spp</span><span class="pathogen-item">Pseudomonas aeruginosa</span><span class="pathogen-item">Enterococos</span><span class="pathogen-item">Levaduras (Candida spp)</span><span class="pathogen-item">Flora polimicrobiana</span></div></div>
|
| 209 |
+
<div class="note-box"><p class="font-medium text-gray-700">Manejo Inicial:</p><ul class="list-disc pl-5 text-gray-600"><li>Evaluar la necesidad real de mantener la sonda. Retirar o cambiar si es posible.</li><li>Recoger urocultivo <strong>tras el cambio de sonda o por punción suprapúbica</strong> si no se puede cambiar, NO de la bolsa colectora.</li><li>Revisar aislamientos y antibiogramas previos del paciente.</li></ul></div>
|
| 210 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento (ajustar según gravedad y previos)</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-notes-medical text-green-500"></i> Tratamiento empírico inicial (si no hay datos previos/gravedad moderada)</div><p class="text-gray-700">Similar a Pielonefritis/ITU complicada, considerar cobertura más amplia:</p><ul class="list-disc pl-5 text-gray-700"><li>Ceftriaxona 2g IV/24h</li><li>Cefepime 1-2g IV/8-12h (si sospecha P. aeruginosa)</li><li>Piperacilina-Tazobactam 4g/0.5g IV/6-8h (cobertura amplia, incl. P. aeruginosa, Enterococo)</li><li>Meropenem 1g IV/8h (si riesgo de BLEE/MDR alto)</li></ul><p class="text-sm text-gray-500 mt-2">Añadir Vancomicina si sospecha S. aureus meticilin-resistente (SAMR) o Enterococo resistente.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Opciones complejas, dependen del tipo de alergia y patógeno sospechado:</p><ul class="list-disc pl-5 text-gray-600"><li>Aztreonam (cubre Gram negativos, NO P. aeruginosa bien, NO Gram positivos ni anaerobios) + Aminoglucósido (Amikacina/Tobramicina)</li><li>Aminoglucósido + Vancomicina (si cubre Gram positivos)</li><li>Consultar especialista en infecciosas.</li></ul></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-history text-blue-500"></i> Ajuste según Cultivo</div><p class="text-gray-700">Imprescindible ajustar el tratamiento al antibiótico de menor espectro posible según el resultado del urocultivo y antibiograma.</p><p class="text-sm text-gray-500 mt-2">Duración: Generalmente 7 días si hay respuesta rápida. Puede ser 10-14 días en casos más graves o bacteriémicos.</p></div></div>
|
| 211 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-procedures text-yellow-500"></i> Medidas preventivas (CAUTI Bundle)</div><ul class="list-disc pl-5 text-gray-700"><li>Insertar sondas sólo por indicación apropiada y personal entrenado.</li><li>Técnica aséptica estricta durante inserción y manipulación.</li><li>Mantener sistema cerrado de drenaje y flujo sin obstrucciones.</li><li>Fijación adecuada para evitar movimiento.</li><li>Higiene perineal diaria.</li><li>Evaluar diariamente la necesidad de la sonda y retirarla lo antes posible.</li><li>Considerar alternativas (colectores externos, sondaje intermitente).</li></ul></div>
|
| 212 |
+
</div>
|
| 213 |
+
</div>
|
| 214 |
+
</div>
|
| 215 |
+
|
| 216 |
+
<div id="content-piel_partes_blandas">
|
| 217 |
+
<div class="space-y-8">
|
| 218 |
+
<div id="absceso_cutaneo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 219 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-cut text-red-500"></i> Absceso Cutáneo</h2>
|
| 220 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Otros (según exposición/localización)</span></div></div>
|
| 221 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico (si indicado¹)</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Cefalexina 0.5-1 g VO cada 8h durante 5 días.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5 días.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-map-marker-alt text-purple-500"></i> Caso específico: Absceso Perianal/Perirectal²</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5-7 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span><br> Ciprofloxacino 500-750 mg VO cada 12h + Metronidazol 500 mg VO cada 8h durante 5 días.</p></div></div>
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<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div><ul class="list-disc text-gray-700 space-y-1"><li>Muchos abscesos cutáneos precisan solo <strong>drenaje</strong>.</li><li>¹Indicación de antibioterapia:<ul><li>Fiebre u otros signos sistémicos de infección.</li><li>Tamaño ≥ 5 cm.</li><li>Celulitis significativa alrededor del absceso.</li><li>Múltiples localizaciones o localizaciones complicadas (cara, mano, genitales).</li><li>Portador de material protésico osteoarticular o cardiovascular.</li><li>Valvulopatía cardíaca significativa.</li><li>Pacientes inmunodeprimidos.</li></ul></li><li>²Si absceso perianal/perirectal, avisar a Cirugía.</li></ul></div>
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</div>
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<div id="erisipela_celulitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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| 225 |
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bacterium text-red-500"></i> Erisipela, Celulitis y Linfangitis (Inicio Comunitario)</h2>
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<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">S. pyogenes</span><span class="pathogen-item">Estreptococos Grupo B, C, G</span><span class="pathogen-item">S. aureus</span><span class="pathogen-item">Bacilos Gramnegativos (en inmunodeprimidos/hepatópatas)</span><span class="pathogen-item">Otros (según exposición)</span></div></div>
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<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-dot-circle text-pink-500"></i> Erisipela</div><p class="text-gray-700"><strong>De elección:</strong> Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 300-600 mg VO cada 8h durante 5-10 días.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-dot-circle text-red-500"></i> Celulitis, Linfangitis o Duda (Erisipela vs Celulitis)</div><p class="text-gray-700"><strong>De elección:</strong> Cefalexina 0.5-1 g VO cada 6-8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 300-600 mg VO cada 8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-exclamation-triangle text-red-600 mr-2"></i><strong>Si sospecha SARM:</strong></span> Clindamicina 300-600 mg/8h VO ó Cotrimoxazol 800/160 mg/12h VO ó Linezolid 600 mg/12h VO.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-procedures text-red-700"></i> Si Criterios de Ingreso</div><p class="text-gray-700"><strong>De elección:</strong> Cefazolina 2 g IV cada 8h durante 7-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 600-900 mg IV cada 8h durante 7-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-exclamation-triangle text-red-600 mr-2"></i><strong>Si sospecha SARM:</strong></span> Añadir Vancomicina 20 mg/kg IV (dosis inicial) seguido de 15 mg/kg/12h IV ó Linezolid 600 mg/12h IV.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-hospital-user text-teal-500 mr-2"></i><strong>HaD (Hospitalización a Domicilio):</strong></span> Ceftriaxona 2 gramos IV cada 24 horas.</p></div></div>
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<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones (Sospecha SARM)</div><p class="text-gray-700 mb-2">Considerar SARM (Staphylococcus aureus Meticilin-Resistente) si:</p><ul class="list-disc text-gray-700 space-y-1"><li>Colonización / Infección previa por SARM (último año).</li><li>Hemodiálisis.</li><li>Múltiples ingresos o ingresos en otros hospitales.</li><li>Pacientes inmigrantes con lesiones necróticas (SARM comunitario).</li><li>Residencia en centro sociosanitario en situación de dependencia.</li></ul></div>
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</div>
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<div id="celulitis_especiales" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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| 231 |
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tint text-cyan-500"></i> Celulitis en Contextos Específicos</h2>
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<div class="treatment-option border-cyan-500"><div class="treatment-title"><i class="fas fa-water text-cyan-600"></i> Celulitis asociada al Agua y Medio Acuático</div><h4 class="font-semibold text-gray-600 mb-1">Agentes etiológicos:</h4><div class="pathogen-list mb-2"><span class="pathogen-item">Vibrio vulnificus (agua salada)</span><span class="pathogen-item">P. aeruginosa</span><span class="pathogen-item">Micobacterias (agua dulce)</span></div><p class="text-gray-700"><strong>De elección:</strong> Ciprofloxacino 750 mg VO cada 12h durante 5-7 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-procedures text-red-500 mr-2"></i><strong>Si gravedad:</strong></span> Ceftazidima 2 g IV cada 8h durante 7-10 días.</p></div>
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| 233 |
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<div class="treatment-option border-gray-500"><div class="treatment-title"><i class="fas fa-shoe-prints text-gray-600"></i> Celulitis asociada a Punción de Pie</div><h4 class="font-semibold text-gray-600 mb-1">Agente etiológico:</h4><div class="pathogen-list mb-2"><span class="pathogen-item">P. aeruginosa</span></div><p class="text-gray-700"><strong>De elección:</strong> Ciprofloxacino 750 mg VO cada 12h durante 5-7 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-procedures text-red-500 mr-2"></i><strong>Si gravedad:</strong></span> Ceftazidima 2 g IV cada 8h durante 7-10 días.</p></div>
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| 234 |
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<div class="treatment-option border-pink-500"><div class="treatment-title"><i class="fas fa-fish text-pink-600"></i> Celulitis asociada a Manejo de Carne o Pescado</div><h4 class="font-semibold text-gray-600 mb-1">Agente etiológico:</h4><div class="pathogen-list mb-2"><span class="pathogen-item">Erysipelothrix rhusiopathiae</span></div><p class="text-gray-700"><strong>De elección:</strong> Amoxicilina 1 g VO cada 8h ó Ciprofloxacino 500 mg VO cada 12h durante 5-7 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-procedures text-red-500 mr-2"></i><strong>Si gravedad:</strong></span> Ceftriaxona 2 g IV cada 24h durante 7-10 días.</p></div>
|
| 235 |
+
</div>
|
| 236 |
+
<div id="mordeduras" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 237 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-tooth text-gray-700"></i> Infección asociada a Mordedura</h2>
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| 238 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Polimicrobianas</span><span class="pathogen-item">Gato: P. multocida</span><span class="pathogen-item">Perro: P. multocida, Capnocytophaga</span><span class="pathogen-item">Rata: Spirillum minor</span><span class="pathogen-item">Humano: Eikenella corrodens</span></div></div>
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| 239 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento / profilaxis</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento/Profilaxis de elección</div><p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h.</p><p class="text-sm text-gray-500 mt-1">Duración: Profilaxis 3-5 días. Tratamiento según características y evolución.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">(Cotrimoxazol 800/160 mg/12h VO ó Doxiciclina 100 mg/12h VO)</p><p class="text-gray-700">+ (Clindamicina 450-600 mg/8h VO ó Metronidazol 500 mg/8h VO)</p><p class="text-sm text-gray-500 mt-1">Duración: Según indicación (profilaxis o tratamiento).</p></div></div>
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| 240 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Indicación de Profilaxis</div><ul class="list-disc text-gray-700 space-y-1"><li>Mordedura profunda (p. ej., gato).</li><li>Afectación significativa de partes blandas.</li><li>Mordeduras en mano, genitales, cara o cerca de articulaciones/prótesis.</li><li>Mordeduras en extremidades con compromiso vascular/linfático.</li><li>Pacientes inmunodeprimidos o diabéticos.</li><li>Mordeduras que requieren sutura.</li></ul></div>
|
| 241 |
+
</div>
|
| 242 |
+
<div id="impetigo" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 243 |
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-child text-yellow-600"></i> Impétigo</h2>
|
| 244 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">S. aureus</span><span class="pathogen-item">S. pyogenes (Grupo A)</span></div></div>
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| 245 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección (tópico)</div><p class="text-gray-700">Ácido fusídico ó Mupirocina tópica cada 8h durante 5-7 días.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Tratamiento sistémico (casos extensos)</div><p class="text-gray-700"><strong>De elección:</strong> Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 300-600 mg VO cada 8h durante 5-10 días.</p></div></div>
|
| 246 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-stethoscope text-yellow-500"></i> Observaciones</div><p class="text-gray-700">El diagnóstico suele ser clínico (impétigo no ampolloso, ampolloso, ectima).</p></div>
|
| 247 |
+
</div>
|
| 248 |
+
<div id="infecciones_profundas" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 249 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-skull-crossbones text-black"></i> Infecciones Profundas y/o Necrotizantes</h2>
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| 250 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Estreptococos (Grupo A o B)</span><span class="pathogen-item">Clostridium</span><span class="pathogen-item">S. aureus</span></div></div>
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| 251 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3><div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div><p class="text-gray-700">Piperacilina/Tazobactam 4.5 g IV cada 6h + Clindamicina 600-900 mg IV cada 8h.</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia a Beta-lactámicos</div><p class="text-gray-700">Vancomicina 25 mg/kg IV (dosis inicial) seguido de 15 mg/kg/12h IV* + Aztreonam 2 g IV cada 8h + Clindamicina 600 mg IV cada 8h*.</p><p class="mt-2 text-gray-700"><strong>O Alternativa Alergia:</strong> Tigeciclina 100 mg IV (dosis inicial) seguido de 50 mg IV cada 12h + Clindamicina 600-900 mg IV cada 8h.</p><p class="text-xs text-gray-500 mt-1">*Sustituir Clindamicina por Metronidazol si sospecha Bacteroides (periné, pared abdominal).</p></div><div class="treatment-option"><div class="treatment-title"><i class="fas fa-exclamation-triangle text-red-600"></i> Si riesgo de SARM</div><p class="text-gray-700">Añadir Linezolid 600 mg IV cada 12h ó Vancomicina 20 mg/kg IV (dosis inicial) seguido de 15 mg/kg/12h IV.</p></div></div>
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| 252 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones Cruciales</div><ul class="list-disc text-gray-700 space-y-1"><li>Consultar <strong>urgentemente</strong> con Cirugía General / Urología: el <strong>desbridamiento amplio/repetido</strong> es crucial.</li><li>Mantener tratamiento IV hasta desaparición de clínica sistémica y desbridamiento completo del tejido necrosado.</li><li>Ajustar dosis de Vancomicina según niveles plasmáticos y función renal.</li></ul></div>
|
| 253 |
+
</div>
|
| 254 |
+
<div id="pie_diabetico" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 255 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-shoe-prints text-red-600"></i> Infección de Pie Diabético</h2>
|
| 256 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><p class="text-gray-600 text-sm mb-2">Varían según gravedad y tratamientos previos:</p><div class="pathogen-list"><span class="pathogen-item">Gram positivos (Leve)</span><span class="pathogen-item">S. aureus (SASM hab.)</span><span class="pathogen-item">S. agalactiae</span><span class="pathogen-item">S. pyogenes</span><span class="pathogen-item">Polimicrobianas (Moderada/Grave)</span><span class="pathogen-item">Enterobacterias</span><span class="pathogen-item">P. aeruginosa</span><span class="pathogen-item">Bacteroides spp</span><span class="pathogen-item">Clostridium</span></div></div>
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| 257 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento empírico</h3><div class="treatment-option border-green-500"><div class="treatment-title"><i class="fas fa-thermometer-empty text-green-600"></i> Pie Diabético - Infección Leve</div><p class="text-gray-700"><strong>De elección:</strong> Cefalexina 0.5-1 g VO cada 6-8h durante 5-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 450-600 mg VO cada 6-8h ó Cotrimoxazol 800/160 mg VO cada 12h, durante 5-10 días.</p></div><div class="treatment-option border-yellow-500"><div class="treatment-title"><i class="fas fa-thermometer-half text-yellow-600"></i> Pie Diabético - Moderada sin Ttos Previos</div><p class="text-gray-700"><strong>De elección:</strong> Cefazolina 2 g IV cada 6-8h durante 7-10 días.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Clindamicina 600-900 mg IV cada 6-8h ó Cotrimoxazol 1600/320 mg VO cada 12h (si es VO), durante 7-10 días.</p></div><div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-thermometer-full text-red-600"></i> Pie Diabético - Infección Grave o Moderada con Ttos Previos</div><p class="text-gray-700"><strong>De elección:</strong> Piperacilina/Tazobactam 4.5 g IV cada 6h + Clindamicina 600-900 mg IV cada 8h.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-exclamation-triangle text-red-600 mr-2"></i><strong>Si riesgo SARM:</strong></span> Añadir Linezolid 600 mg IV cada 12h ó Vancomicina 20 mg/kg IV (dosis inicial) seguido de 15 mg/kg/12h IV.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-shield-virus text-purple-600 mr-2"></i><strong>Si riesgo BLEE:</strong></span> Sustituir Piperacilina/Tazobactam por Meropenem 1 g IV cada 8h.</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-allergies text-orange-500 mr-2"></i><strong>Alergia Beta-lactámicos:</strong></span> Vancomicina 20 mg/kg IV (dosis inicial) seguido de 15 mg/kg/12h IV + Aztreonam 2 g IV cada 8h +/- Clindamicina 600-900 mg IV cada 8h.</p></div></div>
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| 258 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-ruler-combined text-yellow-500"></i> Definición de Gravedad</div><ul class="list-disc text-gray-700 space-y-1"><li><strong>Leve:</strong> ≥2 signos inflamación, pero extensión ≤2 cm bordes lesión, limitada a piel/subcutáneo, sin signos sistémicos.</li><li><strong>Moderada:</strong> (Sin signos sistémicos) Celulitis >2 cm, Linfangitis, Absceso, Afectación tejidos profundos (músculo, tendón, articulación, hueso).</li><li><strong>Grave:</strong> Signos sistémicos (fiebre, tiritona, leucocitosis, taquicardia) +/- hipotensión o disfunción orgánica (hiperlactacidemia, IRA, confusión...).</li><li><strong>Duración:</strong> Depende de profundidad, desbridamiento y evolución. Si no hueso y buena evolución, 7-10 días suelen ser suficientes.</li></ul></div>
|
| 259 |
+
</div>
|
| 260 |
+
<div id="ulceras_presion" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 261 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bed text-blue-700"></i> Infección de Úlceras por Presión (UPP)</h2>
|
| 262 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes (Infección Profunda)</h3><div class="pathogen-list"><span class="pathogen-item">Polimicrobiana</span></div></div>
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| 263 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option border-gray-300"><div class="treatment-title"><i class="fas fa-layer-group text-gray-500"></i> Infección Superficial</div><p class="text-gray-700">No precisa tratamiento antibiótico sistémico. Enfocar en cuidados locales de la herida.</p></div><div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-procedures text-red-600"></i> Infección Profunda</div><p class="text-gray-700 mb-2"><strong>Tratamiento de elección (Cubrir Polimicrobiana y SARM):</strong></p><ul class="list-disc text-gray-700 pl-5 space-y-1"><li>Piperacilina/Tazobactam 4.5 g IV cada 6h</li><li><strong>+</strong> Vancomicina 20 mg/kg IV (dosis inicial) y después 15 mg/kg/12h IV</li><li><em>ó</em> <strong>+</strong> Linezolid 600 mg IV cada 12h (elección si insuficiencia renal)</li></ul><p class="text-sm text-gray-500 mt-2">Duración: Si no afectación ósea, desbridamiento satisfactorio y buena evolución, 7-10 días suelen ser suficientes.</p></div></div>
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| 264 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-stethoscope text-yellow-500"></i> Indicativo de Infección Profunda</div><ul class="list-disc text-gray-700 space-y-1"><li>Celulitis perilesional (no confundir maceración con celulitis).</li><li>Signos/síntomas sistémicos de infección (fiebre, leucocitosis...) o bacteriemia en ausencia de otro foco.</li></ul></div>
|
| 265 |
+
</div>
|
| 266 |
+
<div id="herpes_zoster" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 267 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-virus text-purple-600"></i> Herpes Zoster</h2>
|
| 268 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agente etiológico</h3><div class="pathogen-list"><span class="pathogen-item">Virus Varicela-Zoster (VVZ)</span></div></div>
|
| 269 |
+
<div class="mt-6"><h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de tratamiento</h3><div class="treatment-option border-green-500"><div class="treatment-title"><i class="fas fa-user text-green-600"></i> Presentación Leve o Inmunocompetentes (<72h, >50 años)</div><p class="text-gray-700"><strong>De elección:</strong> Aciclovir 800 mg VO, 5 veces/día durante 7 días (respetando descanso nocturno).</p><p class="mt-2 text-gray-700"><span class="inline-flex items-center"><i class="fas fa-exchange-alt text-blue-500 mr-2"></i><strong>Alternativas:</strong></span></p><ul class="list-disc pl-5 text-gray-700"><li>Valaciclovir 1 g VO cada 8h durante 7 días.</li><li>Famciclovir 500 mg VO cada 8h durante 7 días.</li><li>Brivudina 125 mg VO cada 24h durante 7 días.</li></ul></div><div class="treatment-option border-red-500"><div class="treatment-title"><i class="fas fa-user-shield text-red-600"></i> Presentación Severa o Inmunodeprimidos</div><p class="text-gray-700">Aciclovir 10 mg/kg IV cada 8h durante 7 días.</p></div></div>
|
| 270 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div><ul class="list-disc text-gray-700 space-y-1"><li>En inmunocompetentes, recomendar tratamiento si:<ul><li>Tiempo desde inicio síntomas < 72h.</li><li>Edad > 50 años (mayor beneficio).</li></ul></li><li>En paciente inmunodeprimido, <strong>siempre</strong> hay indicación de tratamiento (IV en casos severos).</li><li>Si afectación ocular (Zoster oftálmico), ótica/auricular (Ramsay Hunt) o neurológica, pueden requerir tratamiento IV.</li><li>Ajustar siempre dosis a función renal.</li><li>Considerar diagnóstico microbiológico si hay dudas.</li></ul></div>
|
| 271 |
+
</div>
|
| 272 |
+
</div>
|
| 273 |
+
</div> <div id="content-orl">
|
| 274 |
+
<div class="space-y-8">
|
| 275 |
+
<div id="otitis_media_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 276 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 277 |
+
<i class="fas fa-ear text-purple-500"></i> Otitis Media Aguda
|
| 278 |
+
</h2>
|
| 279 |
+
<div class="mb-6">
|
| 280 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 281 |
+
<div class="pathogen-list">
|
| 282 |
+
<span class="pathogen-item">S. pneumoniae</span>
|
| 283 |
+
<span class="pathogen-item">H. influenzae</span>
|
| 284 |
+
<span class="pathogen-item">M. catarrhalis</span>
|
| 285 |
+
<span class="pathogen-item">Streptococo grupo A</span>
|
| 286 |
+
</div>
|
| 287 |
+
</div>
|
| 288 |
+
<div class="mt-6">
|
| 289 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento</h3>
|
| 290 |
+
<div class="treatment-option">
|
| 291 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección (si indicado)</div>
|
| 292 |
+
<p class="text-gray-700">Amoxicilina 1 g VO cada 8h.</p>
|
| 293 |
+
<p class="text-xs text-gray-500 mt-1">Indicado si: falta de mejoría tras 48–72 h, fiebre >39ºC, otalgia intensa.</p>
|
| 294 |
+
</div>
|
| 295 |
+
<div class="treatment-option">
|
| 296 |
+
<div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativas / Falta de respuesta / Alergia</div>
|
| 297 |
+
<p class="text-gray-700"><strong>Si no responde o intolerancia:</strong><br>Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h ó Cefditoreno 400 mg VO cada 12h.</p>
|
| 298 |
+
<p class="mt-2 text-gray-700"><strong>Otras alternativas / Alergia:</strong><br>Levofloxacino 500 mg/24h VO, Moxifloxacino 400 mg/24h VO ó Claritromicina 500 mg/12h VO.</p>
|
| 299 |
+
</div>
|
| 300 |
+
</div>
|
| 301 |
+
<div class="note-box mt-6">
|
| 302 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 303 |
+
<ul class="list-disc pl-5 text-gray-700 space-y-1">
|
| 304 |
+
<li>Duración del tratamiento: 10 días.</li>
|
| 305 |
+
<li>En pacientes inmunodeprimidos, valoración especializada por ORL.</li>
|
| 306 |
+
</ul>
|
| 307 |
+
</div>
|
| 308 |
+
</div>
|
| 309 |
+
|
| 310 |
+
<div id="otitis_externa" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 311 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 312 |
+
<i class="fas fa-headphones-alt text-purple-500"></i> Otitis Externa
|
| 313 |
+
</h2>
|
| 314 |
+
<div class="mb-6">
|
| 315 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 316 |
+
<div class="pathogen-list">
|
| 317 |
+
<span class="pathogen-item">Pseudomonas spp</span>
|
| 318 |
+
<span class="pathogen-item">Staphylococcus aureus</span>
|
| 319 |
+
<span class="pathogen-item">Enterobacterias</span>
|
| 320 |
+
<span class="pathogen-item">Anaerobios</span>
|
| 321 |
+
<span class="pathogen-item">Hongos (Aspergillus/Candida)</span>
|
| 322 |
+
</div>
|
| 323 |
+
</div>
|
| 324 |
+
<div class="mt-6">
|
| 325 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (Tópico)</h3>
|
| 326 |
+
<div class="treatment-option">
|
| 327 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección (Bacteriana)</div>
|
| 328 |
+
<p class="text-gray-700">Ciprofloxacino gotas (4 gotas/8h). Combinar con corticoides tópicos si edema del conducto.</p>
|
| 329 |
+
</div>
|
| 330 |
+
<div class="treatment-option">
|
| 331 |
+
<div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Sospecha de Infección Fúngica</div>
|
| 332 |
+
<p class="text-gray-700">Clotrimazol gotas (4 gotas/8h) ó Clioquinol otológico 0.25 mg (4 gotas/8h).</p>
|
| 333 |
+
</div>
|
| 334 |
+
</div>
|
| 335 |
+
<div class="note-box mt-6">
|
| 336 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 337 |
+
<ul class="list-disc pl-5 text-gray-700 space-y-1">
|
| 338 |
+
<li>No mojar ni manipular el oído.</li>
|
| 339 |
+
<li>Considerar tratamiento sistémico si persiste o hay afectación de tejidos blandos periauriculares.</li>
|
| 340 |
+
</ul>
|
| 341 |
+
</div>
|
| 342 |
+
</div>
|
| 343 |
+
|
| 344 |
+
<div id="faringoamigdalitis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 345 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 346 |
+
<i class="fas fa-lungs-virus text-purple-500"></i> Faringoamigdalitis
|
| 347 |
+
</h2>
|
| 348 |
+
<div class="mb-6">
|
| 349 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 350 |
+
<div class="pathogen-list">
|
| 351 |
+
<span class="pathogen-item">Virus (mayoría adultos)</span>
|
| 352 |
+
<span class="pathogen-item">Streptococcus pyogenes (Grupo A)</span>
|
| 353 |
+
</div>
|
| 354 |
+
</div>
|
| 355 |
+
<div class="mt-6">
|
| 356 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (si sospecha bacteriana / confirmada)</h3>
|
| 357 |
+
<div class="treatment-option">
|
| 358 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div>
|
| 359 |
+
<p class="text-gray-700">Penicilina V 500–800 mg VO cada 12h ó Amoxicilina 1 g VO cada 8h.</p>
|
| 360 |
+
</div>
|
| 361 |
+
<div class="treatment-option">
|
| 362 |
+
<div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alternativas / Alergia a Beta-lactámicos</div>
|
| 363 |
+
<p class="text-gray-700">Clindamicina 300 mg VO cada 8h ó Claritromicina 500 mg VO cada 12h.</p>
|
| 364 |
+
</div>
|
| 365 |
+
<div class="treatment-option border-gray-300">
|
| 366 |
+
<div class="treatment-title"><i class="fas fa-info-circle text-gray-500"></i> Tratamiento Sintomático</div>
|
| 367 |
+
<p class="text-gray-700">Hidratación y analgesia adecuadas (especialmente en cuadros víricos).</p>
|
| 368 |
+
</div>
|
| 369 |
+
</div>
|
| 370 |
+
<div class="note-box mt-6">
|
| 371 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 372 |
+
<ul class="list-disc pl-5 text-gray-700 space-y-1">
|
| 373 |
+
<li>Duración del tratamiento antibiótico: 7–10 días.</li>
|
| 374 |
+
<li>Considerar test rápido de detección de antígeno estreptocócico (TRDA) para guiar tratamiento.</li>
|
| 375 |
+
</ul>
|
| 376 |
+
</div>
|
| 377 |
+
</div>
|
| 378 |
+
|
| 379 |
+
<div id="rinosinusitis_aguda" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 380 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 381 |
+
<i class="fas fa-head-side-cough text-purple-500"></i> Rinosinusitis Aguda
|
| 382 |
+
</h2>
|
| 383 |
+
<div class="mb-6">
|
| 384 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 385 |
+
<div class="pathogen-list">
|
| 386 |
+
<span class="pathogen-item">S. pneumoniae</span>
|
| 387 |
+
<span class="pathogen-item">H. influenzae</span>
|
| 388 |
+
<span class="pathogen-item">M. catarrhalis</span>
|
| 389 |
+
<span class="pathogen-item">Rhinovirus (y otros virus)</span>
|
| 390 |
+
</div>
|
| 391 |
+
</div>
|
| 392 |
+
<div class="mt-6">
|
| 393 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (si sospecha bacteriana)</h3>
|
| 394 |
+
<div class="treatment-option">
|
| 395 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div>
|
| 396 |
+
<p class="text-gray-700">Amoxicilina 1 g VO cada 8h.</p>
|
| 397 |
+
</div>
|
| 398 |
+
<div class="treatment-option">
|
| 399 |
+
<div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Si no mejoría en 48h / Alergia</div>
|
| 400 |
+
<p class="text-gray-700"><strong>Falta de mejoría:</strong> Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h ó Cefditoreno 400 mg VO cada 12h (duración total 10 días).</p>
|
| 401 |
+
<p class="mt-2 text-gray-700"><strong>Alergia Beta-lactámicos:</strong> Moxifloxacino 400 mg VO cada 24h.</p>
|
| 402 |
+
</div>
|
| 403 |
+
</div>
|
| 404 |
+
<div class="note-box mt-6">
|
| 405 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 406 |
+
<ul class="list-disc pl-5 text-gray-700">
|
| 407 |
+
<li>Lavados nasales abundantes y descongestionantes son recomendados.</li>
|
| 408 |
+
<li>Considerar antibiótico si síntomas > 10 días, empeoramiento tras mejoría inicial ("doble enfermedad"), o síntomas severos (fiebre alta, dolor facial intenso).</li>
|
| 409 |
+
<li>Realizar imagen (Rx senos o TAC) si sospecha de complicación.</li>
|
| 410 |
+
</ul>
|
| 411 |
+
</div>
|
| 412 |
+
</div>
|
| 413 |
+
|
| 414 |
+
<div id="otomastoiditis" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 415 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 416 |
+
<i class="fas fa-skull text-red-700"></i> Otomastoiditis
|
| 417 |
+
</h2>
|
| 418 |
+
<div class="mb-6">
|
| 419 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 420 |
+
<div class="pathogen-list">
|
| 421 |
+
<span class="pathogen-item">S. pneumoniae</span>
|
| 422 |
+
<span class="pathogen-item">H. influenzae</span>
|
| 423 |
+
<span class="pathogen-item">M. catarrhalis</span>
|
| 424 |
+
<span class="pathogen-item">Streptococo grupo A</span>
|
| 425 |
+
</div>
|
| 426 |
+
</div>
|
| 427 |
+
<div class="mt-6">
|
| 428 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (Requiere Ingreso/Valoración Urgente ORL)</h3>
|
| 429 |
+
<div class="treatment-option">
|
| 430 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento IV de elección</div>
|
| 431 |
+
<p class="text-gray-700">Amoxicilina/Ácido clavulánico 1 g/200 mg IV cada 8h.</p>
|
| 432 |
+
<p class="mt-2 text-gray-700"><strong>Alternativas IV:</strong> Ceftriaxona 1–2 g IV cada 24h ó Cefotaxima 1–2 g IV cada 8h.</p>
|
| 433 |
+
<p class="text-sm text-gray-500 mt-1">Considerar paso a VO según evolución clínica.</p>
|
| 434 |
+
</div>
|
| 435 |
+
<div class="treatment-option">
|
| 436 |
+
<div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alternativa Alergia a Beta-lactámicos</div>
|
| 437 |
+
<p class="text-gray-700">Levofloxacino 500 mg IV cada 24h.</p>
|
| 438 |
+
</div>
|
| 439 |
+
</div>
|
| 440 |
+
<div class="note-box mt-6">
|
| 441 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 442 |
+
<ul class="list-disc pl-5 text-gray-700">
|
| 443 |
+
<li>Requiere valoración urgente por ORL.</li>
|
| 444 |
+
<li>Drenaje quirúrgico (miringotomía +/- tubos, mastoidectomía) puede ser necesario.</li>
|
| 445 |
+
<li>Realizar pruebas de imagen (TAC de peñascos).</li>
|
| 446 |
+
</ul>
|
| 447 |
+
</div>
|
| 448 |
+
</div>
|
| 449 |
+
|
| 450 |
+
<div id="candidiasis_oral" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 451 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 452 |
+
<i class="fas fa-disease text-gray-500"></i> Candidiasis Oral (Muguet)
|
| 453 |
+
</h2>
|
| 454 |
+
<div class="mb-6">
|
| 455 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agente Etiológico</h3>
|
| 456 |
+
<div class="pathogen-list"><span class="pathogen-item">Candida spp.</span></div>
|
| 457 |
+
</div>
|
| 458 |
+
<div class="mt-6">
|
| 459 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento</h3>
|
| 460 |
+
<div class="treatment-option">
|
| 461 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento Tópico de elección</div>
|
| 462 |
+
<p class="text-gray-700">Nistatina suspensión oral 5 mL (500,000 UI) cada 6–8h (enjuagar y tragar) durante 7 días.</p>
|
| 463 |
+
<p class="mt-2 text-gray-700"><strong>Alternativa Tópica:</strong> Miconazol gel oral 2% cada 6h.</p>
|
| 464 |
+
</div>
|
| 465 |
+
<div class="treatment-option">
|
| 466 |
+
<div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Tratamiento Sistémico (Casos refractarios/severos)</div>
|
| 467 |
+
<p class="text-gray-700">Fluconazol 50–100 mg VO cada 24h durante 7 días.</p>
|
| 468 |
+
</div>
|
| 469 |
+
</div>
|
| 470 |
+
<div class="note-box mt-6">
|
| 471 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Observaciones</div>
|
| 472 |
+
<ul class="list-disc pl-5 text-gray-700">
|
| 473 |
+
<li>Realizar cultivo para antifungigrama en candidiasis recurrente o sin respuesta.</li>
|
| 474 |
+
<li>Investigar factores predisponentes (inmunosupresión, xerostomía, corticoides inhalados, prótesis dentales).</li>
|
| 475 |
+
</ul>
|
| 476 |
+
</div>
|
| 477 |
+
</div>
|
| 478 |
+
|
| 479 |
+
<div id="gingivoestomatitis_herpetica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 480 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 481 |
+
<i class="fas fa-mouth-guard text-purple-500"></i> Gingivoestomatitis Herpética
|
| 482 |
+
</h2>
|
| 483 |
+
<div class="mb-6">
|
| 484 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agente Etiológico</h3>
|
| 485 |
+
<div class="pathogen-list"><span class="pathogen-item">Virus Herpes Simple (VHS-1 > VHS-2)</span></div>
|
| 486 |
+
</div>
|
| 487 |
+
<div class="mt-6">
|
| 488 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (Iniciar precozmente)</h3>
|
| 489 |
+
<div class="treatment-option">
|
| 490 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div>
|
| 491 |
+
<p class="text-gray-700">Aciclovir 400 mg VO, 5 veces al día durante 7 días.</p>
|
| 492 |
+
<p class="mt-2 text-gray-700"><strong>Si intolerancia oral / Inmunocompromiso severo:</strong> Aciclovir 5 mg/kg IV cada 8h.</p>
|
| 493 |
+
</div>
|
| 494 |
+
</div>
|
| 495 |
+
<div class="note-box mt-6">
|
| 496 |
+
<div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Notas</div>
|
| 497 |
+
<p class="text-gray-700">Tratamiento sintomático con analgésicos y anestésicos tópicos es importante.</p>
|
| 498 |
+
</div>
|
| 499 |
+
</div>
|
| 500 |
+
|
| 501 |
+
<div id="herpes_labial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 502 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 503 |
+
<i class="fas fa-face-angry text-purple-500"></i> Herpes Labial (Recurrente)
|
| 504 |
+
</h2>
|
| 505 |
+
<div class="mb-6">
|
| 506 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agente Etiológico</h3>
|
| 507 |
+
<div class="pathogen-list"><span class="pathogen-item">Virus Herpes Simple (VHS-1)</span></div>
|
| 508 |
+
</div>
|
| 509 |
+
<div class="mt-6">
|
| 510 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (Iniciar al primer síntoma)</h3>
|
| 511 |
+
<div class="treatment-option">
|
| 512 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento Episódico</div>
|
| 513 |
+
<p class="text-gray-700"><strong>Sistémico (más eficaz):</strong> Aciclovir 400 mg VO, 5 veces/día durante 5 días.</p>
|
| 514 |
+
<p class="mt-2 text-gray-700"><strong>Tópico (menos eficaz):</strong> Aciclovir 5% crema, 4-5 aplic./día durante 4-5 días.</p>
|
| 515 |
+
</div>
|
| 516 |
+
<div class="treatment-option">
|
| 517 |
+
<div class="treatment-title"><i class="fas fa-calendar-alt text-blue-500"></i> Tratamiento Supresor (Recurrencias frecuentes >6/año)</div>
|
| 518 |
+
<p class="text-gray-700">Valaciclovir 500 mg VO cada 24h ó Famciclovir 250 mg VO cada 12h (Evaluar duración, ej. 1 año).</p>
|
| 519 |
+
</div>
|
| 520 |
+
</div>
|
| 521 |
+
</div>
|
| 522 |
+
|
| 523 |
+
<div id="infeccion_odontogenica_no_ingreso" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 524 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 525 |
+
<i class="fas fa-tooth text-red-500"></i> Infección Odontogénica (Ambulatoria)
|
| 526 |
+
</h2>
|
| 527 |
+
<div class="mb-6">
|
| 528 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 529 |
+
<div class="pathogen-list"><span class="pathogen-item">Polimicrobiana (aerobios y anaerobios)</span></div>
|
| 530 |
+
</div>
|
| 531 |
+
<div class="mt-6">
|
| 532 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento</h3>
|
| 533 |
+
<div class="treatment-option">
|
| 534 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div>
|
| 535 |
+
<p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h.</p>
|
| 536 |
+
</div>
|
| 537 |
+
<div class="treatment-option">
|
| 538 |
+
<div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alternativa / Alergia Beta-lactámicos</div>
|
| 539 |
+
<p class="text-gray-700">Clindamicina 300 mg VO cada 6h ó Metronidazol 500 mg VO cada 8h (asociado a otro si cubre aerobios) ó Moxifloxacino 400 mg VO cada 24h.</p>
|
| 540 |
+
</div>
|
| 541 |
+
</div>
|
| 542 |
+
<div class="note-box mt-6">
|
| 543 |
+
<div class="note-title"><i class="fas fa-wrench text-yellow-500"></i> Importante</div>
|
| 544 |
+
<p class="text-gray-700">El tratamiento dental (drenaje, endodoncia, extracción) es fundamental.</p>
|
| 545 |
+
</div>
|
| 546 |
+
</div>
|
| 547 |
+
|
| 548 |
+
<div id="infeccion_odontogenica_ingreso" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 549 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 550 |
+
<i class="fas fa-procedures text-red-700"></i> Infección Odontogénica (Ingreso)
|
| 551 |
+
</h2>
|
| 552 |
+
<div class="mb-6">
|
| 553 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 554 |
+
<div class="pathogen-list">
|
| 555 |
+
<span class="pathogen-item">Polimicrobiana</span>
|
| 556 |
+
<span class="pathogen-item">Actinobacillus</span>
|
| 557 |
+
<span class="pathogen-item">Porphyromonas</span>
|
| 558 |
+
<span class="pathogen-item">Prevotella</span>
|
| 559 |
+
<span class="pathogen-item">Tannerella</span>
|
| 560 |
+
<span class="pathogen-item">Peptostreptococcus</span>
|
| 561 |
+
<span class="pathogen-item">Streptococcus orales</span>
|
| 562 |
+
</div>
|
| 563 |
+
</div>
|
| 564 |
+
<div class="mt-6">
|
| 565 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento IV</h3>
|
| 566 |
+
<div class="treatment-option">
|
| 567 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div>
|
| 568 |
+
<p class="text-gray-700">Amoxicilina/Ácido clavulánico 1 g/200 mg IV cada 8h.</p>
|
| 569 |
+
<p class="text-sm text-gray-500 mt-1">Considerar añadir aminoglucósido (Gentamicina/Tobramicina) si sospecha bacilos Gram-negativos aerobios resistentes o en sepsis grave.</p>
|
| 570 |
+
</div>
|
| 571 |
+
<div class="treatment-option">
|
| 572 |
+
<div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alternativas / Alergia Beta-lactámicos</div>
|
| 573 |
+
<p class="text-gray-700">Clindamicina 600 mg IV cada 8h ó Moxifloxacino 400 mg IV cada 24h.</p>
|
| 574 |
+
<p class="mt-2 text-gray-700"><strong>Otra opción alergia grave:</strong> Vancomicina (dosis según peso/función renal) + Metronidazol 500 mg IV cada 8h.</p>
|
| 575 |
+
</div>
|
| 576 |
+
</div>
|
| 577 |
+
<div class="note-box mt-6">
|
| 578 |
+
<div class="note-title"><i class="fas fa-exclamation-circle text-yellow-500"></i> Criterios de Ingreso / Observaciones</div>
|
| 579 |
+
<ul class="list-disc pl-5 text-gray-700">
|
| 580 |
+
<li>Signos de sepsis / toxicidad sistémica.</li>
|
| 581 |
+
<li>Trismo severo, compromiso vía aérea, extensión a espacios profundos del cuello.</li>
|
| 582 |
+
<li>Inmunocompromiso.</li>
|
| 583 |
+
<li>Necesidad de tratamiento quirúrgico urgente (drenaje).</li>
|
| 584 |
+
<li>Tratamiento dental es crucial.</li>
|
| 585 |
+
</ul>
|
| 586 |
+
</div>
|
| 587 |
+
</div>
|
| 588 |
+
|
| 589 |
+
<div id="sialoadenitis_supurada" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 590 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 591 |
+
<i class="fas fa-head-side-virus text-red-500"></i> Sialoadenitis Aguda Supurada
|
| 592 |
+
</h2>
|
| 593 |
+
<div class="mb-6">
|
| 594 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 595 |
+
<div class="pathogen-list">
|
| 596 |
+
<span class="pathogen-item">Staphylococcus aureus</span>
|
| 597 |
+
<span class="pathogen-item">Streptococcus spp.</span>
|
| 598 |
+
<span class="pathogen-item">Haemophilus influenzae</span>
|
| 599 |
+
<span class="pathogen-item">Escherichia coli</span>
|
| 600 |
+
<span class="pathogen-item">Anaerobios</span>
|
| 601 |
+
</div>
|
| 602 |
+
</div>
|
| 603 |
+
<div class="mt-6">
|
| 604 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (cubrir S. aureus y anaerobios)</h3>
|
| 605 |
+
<div class="treatment-option">
|
| 606 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento de elección</div>
|
| 607 |
+
<p class="text-gray-700">Amoxicilina/Ácido clavulánico 875/125 mg VO cada 8h (si ambulatorio) ó 1 g/200 mg IV cada 8h (si ingreso).</p>
|
| 608 |
+
<p class="text-sm text-gray-500 mt-1">Considerar añadir Metronidazol 500 mg VO/IV cada 8h si sospecha alta de anaerobios o no mejoría.</p>
|
| 609 |
+
</div>
|
| 610 |
+
<div class="treatment-option">
|
| 611 |
+
<div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alternativa / Alergia Beta-lactámicos</div>
|
| 612 |
+
<p class="text-gray-700">Clindamicina 300-600 mg VO cada 8h ó 600 mg IV cada 8h.</p>
|
| 613 |
+
</div>
|
| 614 |
+
</div>
|
| 615 |
+
<div class="note-box mt-6">
|
| 616 |
+
<div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Manejo Adicional</div>
|
| 617 |
+
<ul class="list-disc pl-5 text-gray-700">
|
| 618 |
+
<li>Hidratación, analgésicos, sialogogos (limón, caramelos ácidos), masaje glandular.</li>
|
| 619 |
+
<li>Valorar ecografía o TAC si sospecha de absceso o cálculo.</li>
|
| 620 |
+
<li>Drenaje si absceso.</li>
|
| 621 |
+
</ul>
|
| 622 |
+
</div>
|
| 623 |
+
</div>
|
| 624 |
+
|
| 625 |
+
<div id="fascitis_necrotizante" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 626 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2">
|
| 627 |
+
<i class="fas fa-skull-crossbones text-black"></i> Fascitis Necrotizante Cervicofacial
|
| 628 |
+
</h2>
|
| 629 |
+
<div class="mb-6">
|
| 630 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes Etiológicos</h3>
|
| 631 |
+
<div class="pathogen-list">
|
| 632 |
+
<span class="pathogen-item">Polimicrobiana (Aerobios + Anaerobios)</span>
|
| 633 |
+
<span class="pathogen-item">Streptococcus pyogenes</span>
|
| 634 |
+
<span class="pathogen-item">S. aureus (incl. SARM)</span>
|
| 635 |
+
<span class="pathogen-item">Enterobacterias</span>
|
| 636 |
+
<span class="pathogen-item">Clostridium spp.</span>
|
| 637 |
+
</div>
|
| 638 |
+
</div>
|
| 639 |
+
<div class="mt-6">
|
| 640 |
+
<h3 class="text-lg font-semibold text-gray-700 mb-3 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Opciones de Tratamiento (Urgencia Quirúrgica + Antibiótico Amplio Espectro)</h3>
|
| 641 |
+
<div class="treatment-option">
|
| 642 |
+
<div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Tratamiento Empírico Inicial IV</div>
|
| 643 |
+
<p class="text-gray-700"><strong>Opción 1:</strong> Piperacilina/Tazobactam 4/0.5 g IV cada 6h + Clindamicina 600-900 mg IV cada 8h.</p>
|
| 644 |
+
<p class="mt-2 text-gray-700"><strong>Opción 2:</strong> Meropenem 1 g IV cada 8h + Clindamicina 600-900 mg IV cada 8h.</p>
|
| 645 |
+
<p class="mt-2 text-gray-700"><strong>Añadir cobertura SARM si factores de riesgo:</strong> + Vancomicina ó Linezolid.</p>
|
| 646 |
+
</div>
|
| 647 |
+
<div class="treatment-option">
|
| 648 |
+
<div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alternativa Alergia Beta-lactámicos</div>
|
| 649 |
+
<p class="text-gray-700">Tigeciclina (dosis carga 100mg IV, luego 50mg/12h) ó [Aztreonam + Vancomicina/Linezolid + Metronidazol/Clindamicina]. Consultar infecciosas.</p>
|
| 650 |
+
</div>
|
| 651 |
+
</div>
|
| 652 |
+
<div class="note-box mt-6">
|
| 653 |
+
<div class="note-title"><i class="fas fa-exclamation-triangle text-red-700"></i> ¡¡URGENCIA VITAL!!</div>
|
| 654 |
+
<ul class="list-disc pl-5 text-gray-700">
|
| 655 |
+
<li>Ingreso inmediato (preferiblemente UCI).</li>
|
| 656 |
+
<li>Desbridamiento quirúrgico agresivo y precoz es <strong>imprescindible</strong> y salva vidas.</li>
|
| 657 |
+
<li>Soporte hemodinámico.</li>
|
| 658 |
+
<li>Valoración por Cirugía Maxilofacial / ORL / Cirugía Plástica urgente.</li>
|
| 659 |
+
</ul>
|
| 660 |
+
</div>
|
| 661 |
+
</div>
|
| 662 |
+
|
| 663 |
+
</div>
|
| 664 |
+
</div> </div> <script>
|
| 665 |
+
// --- ELEMENTOS DEL DOM ---
|
| 666 |
+
const mainSelector = document.getElementById('mainGuideSelector');
|
| 667 |
+
const resultDiv = document.getElementById('result');
|
| 668 |
+
const guideStorage = document.getElementById('guide-content-storage');
|
| 669 |
+
|
| 670 |
+
// Selectores específicos y sus contenedores
|
| 671 |
+
const utiSelector = document.getElementById('utiSelector');
|
| 672 |
+
const utiDiv = document.getElementById('utiSubSelectorDiv');
|
| 673 |
+
const ppbSelector = document.getElementById('ppbSelector');
|
| 674 |
+
const ppbDiv = document.getElementById('ppbSubSelectorDiv');
|
| 675 |
+
const orlSelector = document.getElementById('orlSelector');
|
| 676 |
+
const orlDiv = document.getElementById('orlSubSelectorDiv');
|
| 677 |
+
|
| 678 |
+
// Agrupar sub-selectores para facilitar manejo
|
| 679 |
+
const subSelectors = [
|
| 680 |
+
{ selector: utiSelector, container: utiDiv, key: 'infecciones_tracto_urinario_adultos' },
|
| 681 |
+
{ selector: ppbSelector, container: ppbDiv, key: 'piel_partes_blandas' },
|
| 682 |
+
{ selector: orlSelector, container: orlDiv, key: 'orl' }
|
| 683 |
+
];
|
| 684 |
+
|
| 685 |
+
// --- CACHÉ PARA CONTENIDO ---
|
| 686 |
+
let contentCache = {}; // Usar un objeto para cachear múltiples guías
|
| 687 |
+
|
| 688 |
+
// --- MENSAJES REUTILIZABLES ---
|
| 689 |
+
const initialMessage = `<div class="text-center py-12"><div class="mx-auto inline-flex items-center justify-center rounded-full bg-gray-100 p-4 mb-4"><i class="fas fa-book-open text-3xl text-gray-400"></i></div><h3 class="text-lg font-medium text-gray-900">Seleccione una guía para comenzar</h3><p class="mt-1 text-sm text-gray-500">Utilice los menús desplegables para seleccionar la categoría y guía que desea consultar.</p></div>`;
|
| 690 |
+
const selectDiagnosisMessage = (category) => `<div class="text-center py-12"><div class="mx-auto inline-flex items-center justify-center rounded-full bg-blue-100 p-4 mb-4"><i class="fas fa-arrow-down text-3xl text-blue-500"></i></div><h3 class="text-lg font-medium text-gray-900">Seleccione un diagnóstico específico</h3><p class="mt-1 text-sm text-gray-500">Por favor, elija un diagnóstico de ${category} en el menú desplegable para ver la información.</p></div>`;
|
| 691 |
+
const errorMessage = (errorMsg, context, guideId = '') => `<div class="text-center py-12 bg-red-50 p-4 rounded border border-red-200"><div class="mx-auto inline-flex items-center justify-center rounded-full bg-red-100 p-4 mb-4"><i class="fas fa-exclamation-triangle text-3xl text-red-500"></i></div><h3 class="text-lg font-medium text-gray-900">Error al Mostrar Contenido</h3><p class="mt-1 text-sm text-red-700">${context} ${guideId ? `(ID esperado: 'content-${guideId}' o sección específica)` : ''}</p><p class="mt-2 text-xs text-gray-500">Detalle: ${errorMsg}</p></div>`;
|
| 692 |
+
const notFoundMessage = (guideId) => `<div class="text-center py-12 bg-yellow-50 p-4 rounded border border-yellow-200"><div class="mx-auto inline-flex items-center justify-center rounded-full bg-yellow-100 p-4 mb-4"><i class="fas fa-question-circle text-3xl text-yellow-500"></i></div><h3 class="text-lg font-medium text-gray-900">Contenido No Integrado</h3><p class="mt-1 text-sm text-yellow-700">La guía para '${guideId}' no se encontró integrada en este archivo.</p><p class="mt-1 text-xs text-gray-500">Se esperaba encontrar un elemento con ID 'content-${guideId}' dentro del div 'guide-content-storage'.</p></div>`;
|
| 693 |
+
|
| 694 |
+
// --- FUNCIÓN PARA MOSTRAR SECCIÓN ESPECÍFICA ---
|
| 695 |
+
function displaySection(guideKey, sectionId) {
|
| 696 |
+
const contentHtml = contentCache[guideKey];
|
| 697 |
+
if (!contentHtml) {
|
| 698 |
+
resultDiv.innerHTML = errorMessage("Error interno", `El contenido para ${guideKey} no está en caché.`, guideKey);
|
| 699 |
+
return;
|
| 700 |
+
}
|
| 701 |
+
try {
|
| 702 |
+
const parser = new DOMParser();
|
| 703 |
+
const tempDiv = document.createElement('div');
|
| 704 |
+
tempDiv.innerHTML = contentHtml;
|
| 705 |
+
const sectionElement = tempDiv.querySelector(`#${sectionId}`);
|
| 706 |
+
|
| 707 |
+
if (sectionElement) {
|
| 708 |
+
resultDiv.innerHTML = sectionElement.outerHTML;
|
| 709 |
+
} else {
|
| 710 |
+
console.error(`ID '${sectionId}' no encontrado en el HTML interno de ${guideKey}.`);
|
| 711 |
+
resultDiv.innerHTML = errorMessage(`ID de sección no encontrado: '${sectionId}'`, `No se encontró la sección para el diagnóstico seleccionado dentro del contenido de ${guideKey} integrado.`, guideKey);
|
| 712 |
+
}
|
| 713 |
+
} catch (parseError) {
|
| 714 |
+
console.error(`Error parseando/buscando en HTML de ${guideKey}:`, parseError);
|
| 715 |
+
resultDiv.innerHTML = errorMessage(parseError.message, `Ocurrió un error al procesar el contenido de ${guideKey}.`, guideKey);
|
| 716 |
+
}
|
| 717 |
+
}
|
| 718 |
+
|
| 719 |
+
// --- FUNCIÓN PRINCIPAL DE ACTUALIZACIÓN ---
|
| 720 |
+
function updateContent() {
|
| 721 |
+
const mainValue = mainSelector.value;
|
| 722 |
+
|
| 723 |
+
// 1. Resetear estado inicial o si no hay selección
|
| 724 |
+
resultDiv.innerHTML = initialMessage;
|
| 725 |
+
subSelectors.forEach(sub => sub.container.classList.add('hidden')); // Ocultar todos los sub-selectores
|
| 726 |
+
|
| 727 |
+
if (!mainValue) {
|
| 728 |
+
contentCache = {}; // Limpiar toda la caché
|
| 729 |
+
return;
|
| 730 |
+
}
|
| 731 |
+
|
| 732 |
+
// 2. Determinar si la guía seleccionada tiene sub-selector
|
| 733 |
+
const subSelectorInfo = subSelectors.find(sub => sub.key === mainValue);
|
| 734 |
+
|
| 735 |
+
if (subSelectorInfo) {
|
| 736 |
+
// 2a. Guía CON sub-selector (Urología, Piel/PB, ORL)
|
| 737 |
+
const { selector, container, key } = subSelectorInfo;
|
| 738 |
+
const subValue = selector.value;
|
| 739 |
+
|
| 740 |
+
container.classList.remove('hidden'); // Mostrar el sub-selector correcto
|
| 741 |
+
|
| 742 |
+
// Cargar contenido en caché si no está
|
| 743 |
+
if (!contentCache[key]) {
|
| 744 |
+
const contentContainer = document.getElementById(`content-${key}`);
|
| 745 |
+
if (contentContainer) {
|
| 746 |
+
contentCache[key] = contentContainer.innerHTML;
|
| 747 |
+
} else {
|
| 748 |
+
resultDiv.innerHTML = errorMessage(`Contenedor no encontrado`, `No se pudo encontrar el div con ID 'content-${key}' en el HTML.`, key);
|
| 749 |
+
container.classList.add('hidden'); // Ocultar sub-selector si hay error
|
| 750 |
+
return;
|
| 751 |
+
}
|
| 752 |
+
}
|
| 753 |
+
|
| 754 |
+
// Mostrar mensaje o sección según sub-selector
|
| 755 |
+
if (!subValue) {
|
| 756 |
+
// Determinar el nombre de la categoría para el mensaje
|
| 757 |
+
let categoryName = key.replace(/_/g, ' ').replace('infecciones tracto urinario adultos', 'Urología');
|
| 758 |
+
categoryName = categoryName.charAt(0).toUpperCase() + categoryName.slice(1); // Capitalizar
|
| 759 |
+
resultDiv.innerHTML = selectDiagnosisMessage(categoryName);
|
| 760 |
+
} else {
|
| 761 |
+
displaySection(key, subValue);
|
| 762 |
+
}
|
| 763 |
+
|
| 764 |
+
} else {
|
| 765 |
+
// 2b. Guía SIN sub-selector
|
| 766 |
+
const guideContentId = `content-${mainValue}`;
|
| 767 |
+
const guideContentElement = document.getElementById(guideContentId);
|
| 768 |
+
|
| 769 |
+
if (guideContentElement) {
|
| 770 |
+
resultDiv.innerHTML = guideContentElement.innerHTML;
|
| 771 |
+
} else {
|
| 772 |
+
console.warn(`Contenido no encontrado para ID: ${guideContentId}`);
|
| 773 |
+
resultDiv.innerHTML = notFoundMessage(mainValue);
|
| 774 |
+
}
|
| 775 |
+
}
|
| 776 |
+
}
|
| 777 |
+
|
| 778 |
+
// --- EVENT LISTENERS ---
|
| 779 |
+
mainSelector.addEventListener('change', () => {
|
| 780 |
+
// Resetear todos los sub-selectores al cambiar la guía principal
|
| 781 |
+
subSelectors.forEach(sub => sub.selector.value = "");
|
| 782 |
+
updateContent();
|
| 783 |
+
});
|
| 784 |
+
|
| 785 |
+
// Añadir listeners para todos los sub-selectores
|
| 786 |
+
subSelectors.forEach(sub => {
|
| 787 |
+
sub.selector.addEventListener('change', updateContent);
|
| 788 |
+
});
|
| 789 |
+
|
| 790 |
+
// --- INICIALIZACIÓN ---
|
| 791 |
+
updateContent(); // Establecer estado inicial
|
| 792 |
+
|
| 793 |
+
</script>
|
| 794 |
+
|
| 795 |
+
</body>
|
| 796 |
+
</html>
|
proa/respiratorio.html
ADDED
|
@@ -0,0 +1,126 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Respiratorias</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0; border-left: 4px solid #3b82f6; }
|
| 15 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 16 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 17 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 18 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em; }
|
| 19 |
+
h3 { font-size: 1.125rem; font-weight: 500; color: #374151; margin-top: 1rem; }
|
| 20 |
+
</style>
|
| 21 |
+
</head>
|
| 22 |
+
<body class="min-h-screen bg-gray-50">
|
| 23 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 24 |
+
<div class="flex items-center gap-3 mb-6">
|
| 25 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-lungs text-2xl"></i></div>
|
| 26 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Respiratorias</h1>
|
| 27 |
+
</div>
|
| 28 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 29 |
+
<label for="respSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Condición</label>
|
| 30 |
+
<select id="respSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 31 |
+
<option value="">-- Selecciona una condición --</option>
|
| 32 |
+
<option value="epoc">Exacerbación de EPOC</option>
|
| 33 |
+
<option value="bronquiectasias">Bronquiectasias</option>
|
| 34 |
+
<option value="nac">Neumonía Adquirida en la Comunidad</option>
|
| 35 |
+
<option value="nac_especial">Neumonía Especial (Aspirativa/Necrotizante/Inmunodeprimidos)</option>
|
| 36 |
+
<option value="nosocomial">Neumonía Nosocomial</option>
|
| 37 |
+
</select>
|
| 38 |
+
</div>
|
| 39 |
+
<div id="result"></div>
|
| 40 |
+
<div id="guide-content-storage" class="hidden">
|
| 41 |
+
<!-- Exacerbación EPOC -->
|
| 42 |
+
<div id="epoc" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 43 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-lungs text-green-600"></i> Exacerbación de EPOC</h2>
|
| 44 |
+
<h3>Leve (Ambulatorio)</h3>
|
| 45 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Amoxicilina/Clavulánico 875/125 mg VO c/8 h por 5 días.</p></div>
|
| 46 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p>Cefditoreno 200-400 mg VO c/12 h.</p></div>
|
| 47 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p>Moxifloxacino 400 mg VO c/24 h o Levofloxacino 500 mg VO c/24 h.</p></div>
|
| 48 |
+
<h3>Moderada/Grave sin riesgo de P. aeruginosa</h3>
|
| 49 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Moxifloxacino 400 mg VO c/24 h o Levofloxacino 500 mg VO c/24 h.</p></div>
|
| 50 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p>Amoxicilina/Clavulánico 875/125 mg VO c/8 h o Ceftriaxona 1-2 g IV.</p></div>
|
| 51 |
+
<h3>Moderada/Grave con riesgo de P. aeruginosa</h3>
|
| 52 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Levofloxacino 500 mg VO/IV c/12 h o Ciprofloxacino 750 mg VO c/12 h.</p></div>
|
| 53 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativa</div><p>Ceftazidima 2 g IV c/8 h o Meropenem 1 g IV c/6-8 h.</p></div>
|
| 54 |
+
<h3>Con Influenza confirmada</h3>
|
| 55 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-virus text-red-500"></i> Antivírico</div><p>Oseltamivir 75 mg VO c/12 h por 5 días (prueba PCR o Ag).</p></div>
|
| 56 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700 ml-5"><li>Iniciar ATB si ≥2 criterios de Anthonisen.</li><li>Obtener cultivo de esputo si es posible.</li><li>No realizar antigenuria para neumococo/Legionella.</li></ul></div>
|
| 57 |
+
</div>
|
| 58 |
+
<!-- Bronquiectasias -->
|
| 59 |
+
<div id="bronquiectasias" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 60 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bacteria text-teal-600"></i> Bronquiectasias</h2>
|
| 61 |
+
<h3>Agudización leve-moderada (Ambulatorio)</h3>
|
| 62 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> H. influenzae</div><p>Amoxicilina/Clavulánico 875/125 mg VO c/8 h por 10-21 días.</p></div>
|
| 63 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> S. aureus</div><p>Cloxacilina 500-1000 mg VO c/6 h. Alergia: Cotrimoxazol 160/800 mg VO c/12 h.</p></div>
|
| 64 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> P. aeruginosa</div><p>Ciprofloxacino 750 mg VO c/12 h. Alternativa: Levofloxacino 750 mg VO c/24 h.</p></div>
|
| 65 |
+
<h3>Agudización grave (Hospitalización)</h3>
|
| 66 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> H. influenzae</div><p>Amoxicilina/Clavulánico IV 1-2 g c/8 h o Ceftriaxona 2 g IV/24 h.</p></div>
|
| 67 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-prescription text-green-500"></i> S. aureus</div><p>Cloxacilina 1-2 g IV c/4-6 h. Alergia: Vancomicina 15-20 mg/kg IV c/8-12 h.</p></div>
|
| 68 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700 ml-5"><li>Obtener cultivo de esputo.</li><li>Duración 10-21 días.</li></ul></div>
|
| 69 |
+
</div>
|
| 70 |
+
<!-- Neumonía Adquirida en la Comunidad -->
|
| 71 |
+
<div id="nac" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 72 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-home text-blue-600"></i> Neumonía Adquirida en la Comunidad</h2>
|
| 73 |
+
<h3>Ambulatoria (PSI <70 / CURB-65=0)</h3>
|
| 74 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Amoxicilina 1 g VO c/8 h (o Amox/Clav 875/125 mg VO c/8 h si >65 años, comorbilidad).</p></div>
|
| 75 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-plus text-blue-500"></i> Macrólido</div><p>Azitromicina 500 mg VO/día por 3 días (sospecha atípicas).</p></div>
|
| 76 |
+
<h3>Ingreso hospitalario (PSI 71-130 / CURB-65=1-2)</h3>
|
| 77 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Beta-lactámico</div><p>Amox/Clav IV 1-2 g c/8 h o Ceftriaxona 1-2 g IV/24 h.</p></div>
|
| 78 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-plus text-blue-500"></i> Macrólido</div><p>Azitromicina 500 mg IV/24 h o Levofloxacino 500 mg IV c/12 h.</p></div>
|
| 79 |
+
<h3>UCI (PSI >130 / CURB-65 >2)</h3>
|
| 80 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Ceftriaxona</div><p>Ceftriaxona 2 g IV c/12 h + Azitromicina o Levofloxacino.</p></div>
|
| 81 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700 ml-5"><li>No requiere microbiología en ambulatorio.</li><li>En temporada gripal considerar oseltamivir.</li></ul></div>
|
| 82 |
+
</div>
|
| 83 |
+
<!-- Neumonía Especial -->
|
| 84 |
+
<div id="nac_especial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 85 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-skull-crossbones text-purple-600"></i> Neumonía Especial</h2>
|
| 86 |
+
<h3>Broncoaspiración</h3>
|
| 87 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Amoxicilina/Clavulánico 2 g IV c/8 h.</p></div>
|
| 88 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p>Clindamicina 600 mg IV c/8 h + Levofloxacino 500 mg IV.</p></div>
|
| 89 |
+
<h3>Neumonía necrotizante/absceso</h3>
|
| 90 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Amoxicilina/Clavulánico 2 g IV c/6-8 h.</p></div>
|
| 91 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p>Clindamicina 600-900 mg IV c/8 h.</p></div>
|
| 92 |
+
<h3>Paciente inmunodeprimido</h3>
|
| 93 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Pseudomonas</div><p>Cefepime 2 g IV c/8 h o Piperacilina/Tazobactam 4.5 g IV c/6 h.</p></div>
|
| 94 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> PCP</div><p>Cotrimoxazol 15 mg/kg/día IV dividido en 3-4 dosis ± Metilprednisolona.</p></div>
|
| 95 |
+
</div>
|
| 96 |
+
<!-- Neumonía Nosocomial -->
|
| 97 |
+
<div id="nosocomial" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 98 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-hospital text-red-700"></i> Neumonía Nosocomial</h2>
|
| 99 |
+
<h3>No grave, sin resistencia</h3>
|
| 100 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p>Ceftriaxona 2 g IV/24 h.</p></div>
|
| 101 |
+
<h3>No grave, con resistencia</h3>
|
| 102 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p>Cefepime 2 g IV c/8 h + Linezolid 600 mg IV c/12 h.</p></div>
|
| 103 |
+
<h3>Grave o VMI/factores riesgo</h3>
|
| 104 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Elección</div><p>Imipenem 1 g IV c/8 h o Meropenem 2 g IV c/8 h + Amikacina 1 g IV/24 h.</p></div>
|
| 105 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle text-blue-500"></i> Observaciones</div><ul class="list-disc text-gray-700 ml-5"><li>Duración 5-14 días según severidad.</li><li>Obtener cultivos, secuenciar a VO cuando sea posible.</li></ul></div>
|
| 106 |
+
</div>
|
| 107 |
+
</div>
|
| 108 |
+
<script>
|
| 109 |
+
const sel = document.getElementById('respSelector');
|
| 110 |
+
const res = document.getElementById('result');
|
| 111 |
+
const st = document.getElementById('guide-content-storage');
|
| 112 |
+
sel.addEventListener('change', () => {
|
| 113 |
+
res.innerHTML = '';
|
| 114 |
+
const id = sel.value;
|
| 115 |
+
if (!id) return;
|
| 116 |
+
const node = st.querySelector('#' + id);
|
| 117 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 118 |
+
});
|
| 119 |
+
</script>
|
| 120 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 121 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 122 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 123 |
+
</div>
|
| 124 |
+
</div>
|
| 125 |
+
</body>
|
| 126 |
+
</html>
|
proa/respiratorio_pediatrico.html
ADDED
|
@@ -0,0 +1,152 @@
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Respiratorio Pediátrico</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 15 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 16 |
+
li { margin-bottom: 0.25rem; }
|
| 17 |
+
</style>
|
| 18 |
+
</head>
|
| 19 |
+
<body class="min-h-screen bg-gray-50">
|
| 20 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 21 |
+
<div class="flex items-center gap-3 mb-6">
|
| 22 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-lungs text-2xl"></i></div>
|
| 23 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Respiratorio Pediátrico</h1>
|
| 24 |
+
</div>
|
| 25 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 26 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Escenario</label>
|
| 27 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 28 |
+
<option value="">-- Selecciona un escenario --</option>
|
| 29 |
+
<option value="ambulatorio_4m_4a_viral">Ambulatorio 4m-4a: Sospecha vírica</option>
|
| 30 |
+
<option value="ambulatorio_4m_4a_tipica_vac">Ambulatorio 4m-4a: Neumonía típica (vacunados Hib)</option>
|
| 31 |
+
<option value="ambulatorio_4m_4a_tipica_no_vac">Ambulatorio 4m-4a: Neumonía típica (no vacunados/coinf. gripal)</option>
|
| 32 |
+
<option value="ambulatorio_4m_4a_atipica">Ambulatorio 4m-4a: Neumonía atípica</option>
|
| 33 |
+
<option value="ambulatorio_5m_mayores_tipica">Ambulatorio ≥5a: Neumonía típica</option>
|
| 34 |
+
<option value="ambulatorio_5m_mayores_atipica">Ambulatorio ≥5a: Neumonía atípica</option>
|
| 35 |
+
<option value="hosp_0_4s">Hospitalizados 0-4 semanas</option>
|
| 36 |
+
<option value="hosp_1_3m">Hospitalizados 1-3 meses</option>
|
| 37 |
+
<option value="hosp_4m_4a">Hospitalizados 4m-4a</option>
|
| 38 |
+
<option value="hosp_mayores5">Hospitalizados >5 años</option>
|
| 39 |
+
<option value="especial_aspiracion">Situaciones especiales: Aspiración</option>
|
| 40 |
+
<option value="especial_inmune_no_grave">Situaciones especiales: Inmunodepresión no grave</option>
|
| 41 |
+
<option value="especial_inmune_grave">Situaciones especiales: Inmunodepresión grave</option>
|
| 42 |
+
<option value="especial_nosocomial_precoz">Situaciones especiales: Neumonía nosocomial precoz (<5d)</option>
|
| 43 |
+
<option value="especial_nosocomial_tardia">Situaciones especiales: Neumonía nosocomial tardía (>5d)</option>
|
| 44 |
+
</select>
|
| 45 |
+
</div>
|
| 46 |
+
<div id="result" class="space-y-6"></div>
|
| 47 |
+
|
| 48 |
+
<div id="guide-content-storage" class="hidden">
|
| 49 |
+
<!-- Ambulatorio 4m-4a Viral -->
|
| 50 |
+
<div id="ambulatorio_4m_4a_viral" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 51 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-virus text-purple-600"></i> Ambulatorio 4m-4a: Sospecha vírica</h2>
|
| 52 |
+
<p class="text-gray-700">No se recomienda tratamiento antibiótico empírico.</p>
|
| 53 |
+
<div class="mt-4 text-sm text-gray-600">Revaluar si empeora o persiste >48-72h.</div>
|
| 54 |
+
</div>
|
| 55 |
+
<!-- Ambulatorio 4m-4a Típica vacunados -->
|
| 56 |
+
<div id="ambulatorio_4m_4a_tipica_vac" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 57 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Ambulatorio 4m-4a: Neumonía típica (vacunados Hib)</h2>
|
| 58 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Amoxicilina VO 80-90 mg/kg/día en 3 dosis (máx. 4-6 g/día) durante 5-7 días.</p>
|
| 59 |
+
<div class="mt-4 text-sm text-gray-600">Si mala respuesta a 48-72h, añadir o cambiar a azitromicina.</div>
|
| 60 |
+
</div>
|
| 61 |
+
<!-- Ambulatorio 4m-4a Típica no vacunados -->
|
| 62 |
+
<div id="ambulatorio_4m_4a_tipica_no_vac" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 63 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Ambulatorio 4m-4a: Neumonía típica (no vacunados/coinf. gripal)</h2>
|
| 64 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Amoxicilina-Clavulánico VO 80-90 mg/kg/día de amoxicilina + clavulánico (máx. 375 mg/día) en 3 dosis durante 5-7 días.</p>
|
| 65 |
+
</div>
|
| 66 |
+
<!-- Ambulatorio 4m-4a Atípica -->
|
| 67 |
+
<div id="ambulatorio_4m_4a_atipica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 68 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Ambulatorio 4m-4a: Neumonía atípica</h2>
|
| 69 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Azitromicina VO 10 mg/kg cada 24h (máx. 500 mg) durante 3 días.</p>
|
| 70 |
+
</div>
|
| 71 |
+
<!-- Ambulatorio ≥5 Tipica -->
|
| 72 |
+
<div id="ambulatorio_5m_mayores_tipica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 73 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Ambulatorio ≥5a: Neumonía típica</h2>
|
| 74 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Amoxicilina VO 80-90 mg/kg/día en 3 dosis (máx. 4-6 g/día) durante 5-7 días.</p>
|
| 75 |
+
</div>
|
| 76 |
+
<!-- Ambulatorio ≥5 Atipica -->
|
| 77 |
+
<div id="ambulatorio_5m_mayores_atipica" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 78 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Ambulatorio ≥5a: Neumonía atípica</h2>
|
| 79 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Azitromicina VO 10 mg/kg cada 24h (máx. 500 mg) durante 3 días.<br><strong>Alternativa:</strong> Claritromicina VO 7,5 mg/kg/12h (máx. 1 g/día) 5 días.</p>
|
| 80 |
+
</div>
|
| 81 |
+
<!-- Hospitalizados 0-4 semanas -->
|
| 82 |
+
<div id="hosp_0_4s" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 83 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-hospital text-red-600"></i> Hospitalizados 0-4 semanas</h2>
|
| 84 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Ampicilina IV 37,5-75 mg/kg c/6h (máx. 12 g/día) + Gentamicina IV 5-7,5 mg/kg/día 7 días.<br>Si grave o derrame pleural: ampliar a 10-14 días.</p>
|
| 85 |
+
</div>
|
| 86 |
+
<!-- Hospitalizados 1-3 meses -->
|
| 87 |
+
<div id="hosp_1_3m" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 88 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-hospital text-red-600"></i> Hospitalizados 1-3 meses</h2>
|
| 89 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Ampicilina IV 37,5-75 mg/kg c/6h + Cefotaxima IV 137,5-75 mg/kg c/6h 7 días.<br>Si grave o derrame pleural: 10-14 días.</p>
|
| 90 |
+
</div>
|
| 91 |
+
<!-- Hospitalizados 4m-4a -->
|
| 92 |
+
<div id="hosp_4m_4a" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 93 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-hospital text-red-600"></i> Hospitalizados 4m-4a: Neumonía típica</h2>
|
| 94 |
+
<p class="text-gray-700"><strong>Tratamiento:</strong> Ampicilina IV 37,5-75 mg/kg c/6h 7 días.</p>
|
| 95 |
+
<p class="mt-2 text-gray-700"><strong><6m no vacunados/coinf.gripal:</strong> Amoxicilina-Clavulánico IV 100-150 mg/kg/día en 3-4 dosis 7 días.</p>
|
| 96 |
+
<p class="mt-2 text-gray-700"><strong>Alergia:</strong> Tipo I: Levofloxacino IV 10 mg/kg c/12h; Sin I: Cefotaxima IV 37,5-75 mg/kg c/6h.</p>
|
| 97 |
+
<p class="mt-2 text-gray-700"><strong>Derrame:</strong> Ampicilina 75 mg/kg c/6h 10-14 días.</p>
|
| 98 |
+
<p class="mt-2 text-gray-700"><strong>Necrosante/absceso:</strong> Cefotaxima + Clindamicina IV 7,5-10 mg/kg c/6h 14 días.</p>
|
| 99 |
+
</div>
|
| 100 |
+
<!-- Hospitalizados >5 años -->
|
| 101 |
+
<div id="hosp_mayores5" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 102 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-hospital text-red-600"></i> Hospitalizados >5 años</h2>
|
| 103 |
+
<p class="text-gray-700"><strong>Típica:</strong> Ampicilina IV 37,5-75 mg/kg c/6h 7 días (alergia similar a <5a).</p>
|
| 104 |
+
<p class="mt-2 text-gray-700"><strong>Atípica:</strong> Azitromicina VO 10 mg/kg c/24h 3 días.</p>
|
| 105 |
+
</div>
|
| 106 |
+
<!-- Especial Aspiración -->
|
| 107 |
+
<div id="especial_aspiracion" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 108 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-exchange-alt text-orange-500"></i> Situaciones especiales: Aspiración</h2>
|
| 109 |
+
<p class="text-gray-700"><strong>De elección:</strong> Amoxicilina-Clavulánico IV 100-150 mg/kg/día en 3 dosis 10 días.<br><strong>Alternativa:</strong> Clindamicina IV 7,5-10 mg/kg ± Gentamicina 5,5-7,5 mg/kg/día 10-14 días.</p>
|
| 110 |
+
</div>
|
| 111 |
+
<!-- Especial Inmunodepresión no grave -->
|
| 112 |
+
<div id="especial_inmune_no_grave" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 113 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-user-shield text-red-600"></i> Situaciones especiales: Inmunodepresión no grave</h2>
|
| 114 |
+
<p class="text-gray-700">Cefotaxima IV 37,5 mg/kg c/6h 14 días.</p>
|
| 115 |
+
</div>
|
| 116 |
+
<!-- Especial Inmunodepresión grave -->
|
| 117 |
+
<div id="especial_inmune_grave" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 118 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-user-shield text-black"></i> Situaciones especiales: Inmunodepresión grave</h2>
|
| 119 |
+
<p class="text-gray-700">Cefepime IV 50 mg/kg c/8h 14 días.</p>
|
| 120 |
+
</div>
|
| 121 |
+
<!-- Especial Nosocomial Precoz -->
|
| 122 |
+
<div id="especial_nosocomial_precoz" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 123 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-hospital-user text-purple-600"></i> Situaciones especiales: Neumonía nosocomial precoz (<5d)</h2>
|
| 124 |
+
<p class="text-gray-700">Cefotaxima IV 37,5 mg/kg c/6h 14 días.</p>
|
| 125 |
+
</div>
|
| 126 |
+
<!-- Especial Nosocomial Tardía -->
|
| 127 |
+
<div id="especial_nosocomial_tardia" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 128 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4"><i class="fas fa-hospital-user text-purple-600"></i> Situaciones especiales: Neumonía nosocomial tardía (>5d)</h2>
|
| 129 |
+
<p class="text-gray-700">Cefepime IV 50 mg/kg c/8h + Amikacina IV 7,5-10 mg/kg c/12h 14 días.</p>
|
| 130 |
+
</div>
|
| 131 |
+
</div>
|
| 132 |
+
|
| 133 |
+
<script>
|
| 134 |
+
const sel = document.getElementById('diagnosticSelector');
|
| 135 |
+
const res = document.getElementById('result');
|
| 136 |
+
const storage = document.getElementById('guide-content-storage');
|
| 137 |
+
sel.addEventListener('change', () => {
|
| 138 |
+
res.innerHTML = '';
|
| 139 |
+
const id = sel.value;
|
| 140 |
+
if (!id) return;
|
| 141 |
+
const node = storage.querySelector('#' + id);
|
| 142 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 143 |
+
});
|
| 144 |
+
</script>
|
| 145 |
+
|
| 146 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 147 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 148 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 149 |
+
</div>
|
| 150 |
+
</div>
|
| 151 |
+
</body>
|
| 152 |
+
</html>
|
proa/sindrome_febril_agudo_pediatrico.html
ADDED
|
@@ -0,0 +1,125 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Síndrome Febril Agudo sin Foco Pediátrico</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { background-color: white; border: 1px solid #e5e7eb; border-radius: 0.75rem; padding: 1.5rem; transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin-top: 1rem; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin-top: 1rem; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-thermometer-half text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Síndrome Febril Agudo sin Foco (Pediátrico)</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="selector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Escenario</label>
|
| 33 |
+
<select id="selector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 34 |
+
<option value="">-- Selecciona un escenario --</option>
|
| 35 |
+
<option value="menor1mes">Menor de 1 mes</option>
|
| 36 |
+
<option value="lactantes1_3">1-3 meses</option>
|
| 37 |
+
<option value="ninos3_36">3-36 meses</option>
|
| 38 |
+
</select>
|
| 39 |
+
</div>
|
| 40 |
+
<div id="result" class="space-y-6"></div>
|
| 41 |
+
|
| 42 |
+
<div id="guide-content" class="hidden">
|
| 43 |
+
<!-- Menor 1 mes -->
|
| 44 |
+
<div id="menor1mes" class="treatment-card">
|
| 45 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-baby text-blue-500"></i> Menor de 1 mes</h2>
|
| 46 |
+
<h3 class="font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 47 |
+
<div class="pathogen-list">
|
| 48 |
+
<span class="pathogen-item">S. agalactiae</span>
|
| 49 |
+
<span class="pathogen-item">E. coli</span>
|
| 50 |
+
<span class="pathogen-item">Enterobacterias</span>
|
| 51 |
+
<span class="pathogen-item">L. monocytogenes</span>
|
| 52 |
+
<span class="pathogen-item">Enterococos</span>
|
| 53 |
+
</div>
|
| 54 |
+
<h3 class="font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 55 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Ampicilina IV 50 mg/kg c/12h (<7d) o c/8h (>7d) + Gentamicina IV 4 mg/kg/día.</p></div>
|
| 56 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-exclamation-triangle text-blue-500"></i> Sospecha de meningitis</div><p>Ampicilina IV 65-100 mg/kg c/8h (<7d) o 75 mg/kg c/6h (>7d) + Cefotaxima IV 50 mg/kg c/6h.</p></div>
|
| 57 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle"></i> Observaciones</div>
|
| 58 |
+
<ul>
|
| 59 |
+
<li>Neonatos con buen estado y pruebas normales: ingresar sin antibiótico, observar y repetir cultivos.</li>
|
| 60 |
+
<li>Alta precoz tras 48h de cultivos negativos con seguimiento estrecho.</li>
|
| 61 |
+
</ul>
|
| 62 |
+
</div>
|
| 63 |
+
</div>
|
| 64 |
+
<!-- Lactantes 1-3 meses -->
|
| 65 |
+
<div id="lactantes1_3" class="treatment-card">
|
| 66 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-infant text-purple-600"></i> Lactantes (1-3 meses)</h2>
|
| 67 |
+
<h3 class="font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 68 |
+
<div class="pathogen-list">
|
| 69 |
+
<span class="pathogen-item">Neumococo</span>
|
| 70 |
+
<span class="pathogen-item">Meningococo</span>
|
| 71 |
+
<span class="pathogen-item">H. influenzae</span>
|
| 72 |
+
<span class="pathogen-item">S. agalactiae</span>
|
| 73 |
+
<span class="pathogen-item">E. coli</span>
|
| 74 |
+
<span class="pathogen-item">L. monocytogenes</span>
|
| 75 |
+
</div>
|
| 76 |
+
<h3 class="font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 77 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> No bajo riesgo</div><p>Ampicilina IV 50 mg/kg c/6h + Gentamicina IV 4 mg/kg/día.</p></div>
|
| 78 |
+
<div class="treatment-option border-blue-500"><div class="treatment-title"><i class="fas fa-exclamation-triangle text-blue-500"></i> Sospecha meningitis</div><p>Cefotaxima IV 50-75 mg/kg c/6h + Ampicilina IV 50 mg/kg c/6h.</p></div>
|
| 79 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle"></i> Bajo riesgo</div>
|
| 80 |
+
<p class="text-gray-700">Criterios clínicos (YIOS <7) y analíticos (leucocitos 5-15k, neutrófilos <10k, PCR <20, PCT <0.5, tira orina negativa). Repetir analítica a 6h; si estable, observar sin antibiótico.</p>
|
| 81 |
+
</div>
|
| 82 |
+
</div>
|
| 83 |
+
<!-- Niños 3-36 meses -->
|
| 84 |
+
<div id="ninos3_36" class="treatment-card">
|
| 85 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-child text-green-600"></i> Niños (3-36 meses)</h2>
|
| 86 |
+
<h3 class="font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 87 |
+
<div class="pathogen-list">
|
| 88 |
+
<span class="pathogen-item">Neumococo</span>
|
| 89 |
+
<span class="pathogen-item">Meningococo</span>
|
| 90 |
+
<span class="pathogen-item">H. influenzae</span>
|
| 91 |
+
<span class="pathogen-item">Salmonella spp.</span>
|
| 92 |
+
</div>
|
| 93 |
+
<h3 class="font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 94 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> Estado grave (YALE >15)</div><p>Cefotaxima IV 50 mg/kg c/6h ± Vancomicina IV 10 mg/kg c/6h.</p></div>
|
| 95 |
+
<div class="treatment-option border-green-500"><div class="treatment-title"><i class="fas fa-home text-green-500"></i> Posible alta</div><p>Ceftriaxona IM/IV 50 mg/kg dosis única, luego Amoxicilina VO 25-30 mg/kg c/8h hasta cultivos.</p></div>
|
| 96 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle"></i> Observaciones</div>
|
| 97 |
+
<ul>
|
| 98 |
+
<li>Buen estado (YALE <11) y T <39°C: alta sin antibiótico.</li>
|
| 99 |
+
<li>T ≥39°C: estudio de orina y vacunación; según resultados, valorar antibioterapia.</li>
|
| 100 |
+
<li>Elevación de PCR >30 mg/L o PCT >0.5 ng/mL: iniciar antibioterapia.</li>
|
| 101 |
+
</ul>
|
| 102 |
+
</div>
|
| 103 |
+
</div>
|
| 104 |
+
</div>
|
| 105 |
+
|
| 106 |
+
<script>
|
| 107 |
+
const sel = document.getElementById('selector');
|
| 108 |
+
const res = document.getElementById('result');
|
| 109 |
+
const storage = document.getElementById('guide-content');
|
| 110 |
+
sel.addEventListener('change', () => {
|
| 111 |
+
res.innerHTML = '';
|
| 112 |
+
const id = sel.value;
|
| 113 |
+
if (!id) return;
|
| 114 |
+
const node = storage.querySelector('#' + id);
|
| 115 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 116 |
+
});
|
| 117 |
+
</script>
|
| 118 |
+
|
| 119 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 120 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 121 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 122 |
+
</div>
|
| 123 |
+
</div>
|
| 124 |
+
</body>
|
| 125 |
+
</html>
|
proa/sistema_nervioso_central_pediatrico.html
ADDED
|
@@ -0,0 +1,124 @@
|
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|
|
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|
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|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
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|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - SNC Pediátrico</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { background-color: white; border: 1px solid #e5e7eb; border-radius: 0.75rem; padding: 1.5rem; transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin-top: 1rem; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin-top: 1rem; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
</style>
|
| 24 |
+
</head>
|
| 25 |
+
<body class="min-h-screen bg-gray-50">
|
| 26 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 27 |
+
<div class="flex items-center gap-3 mb-6">
|
| 28 |
+
<div class="bg-blue-600 p-2 rounded-lg text-white"><i class="fas fa-brain text-2xl"></i></div>
|
| 29 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Sistema Nervioso Central (Pediátrico)</h1>
|
| 30 |
+
</div>
|
| 31 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 32 |
+
<label for="selector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-red-500"></i> Selecciona</label>
|
| 33 |
+
<select id="selector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 34 |
+
<option value="">-- Escenario clínico --</option>
|
| 35 |
+
<option value="neonatal">Meningitis Neonatal (<1 mes)</option>
|
| 36 |
+
<option value="lactantes">Meningitis Lactantes (1-3 meses)</option>
|
| 37 |
+
<option value="mayores">Meningitis (>3 meses)</option>
|
| 38 |
+
<option value="alergia">Manejo: Alergia Beta-lactámicos</option>
|
| 39 |
+
<option value="dexametasona">Uso de Dexametasona</option>
|
| 40 |
+
<option value="duracion">Duración del Tratamiento</option>
|
| 41 |
+
</select>
|
| 42 |
+
</div>
|
| 43 |
+
<div id="result" class="space-y-6"></div>
|
| 44 |
+
|
| 45 |
+
<div id="guide-content" class="hidden">
|
| 46 |
+
<!-- Neonatal -->
|
| 47 |
+
<div id="neonatal" class="treatment-card">
|
| 48 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-baby text-blue-500"></i> Neonatal (<1 mes)</h2>
|
| 49 |
+
<h3 class="font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 50 |
+
<div class="pathogen-list"><span class="pathogen-item">S. agalactiae</span><span class="pathogen-item">E. coli</span><span class="pathogen-item">L. monocytogenes</span></div>
|
| 51 |
+
<h3 class="font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 52 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Cefotaxima IV 300 mg/kg/día c/6h + Ampicilina IV 300 mg/kg/día c/6h.</p></div>
|
| 53 |
+
<div class="treatment-option border-orange-500"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia confirmada</div><p>Aztreonam IV 150 mg/kg/día c/6h + Vancomicina IV 60 mg/kg/día c/6h <br>o Levofloxacino 10 mg/kg/día c/24h (<i>≥6m: 20 mg/kg/día c/12h</i>).</p></div>
|
| 54 |
+
</div>
|
| 55 |
+
<!-- Lactantes -->
|
| 56 |
+
<div id="lactantes" class="treatment-card">
|
| 57 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-infant text-purple-600"></i> Lactantes (1-3 meses)</h2>
|
| 58 |
+
<h3 class="font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 59 |
+
<div class="pathogen-list"><span class="pathogen-item">S. agalactiae</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">E. coli</span><span class="pathogen-item">N. meningitidis</span><span class="pathogen-item">L. monocytogenes</span><span class="pathogen-item">S. pneumoniae</span></div>
|
| 60 |
+
<h3 class="font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 61 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Cefotaxima IV 300 mg/kg/día c/6h <i>o</i> Ceftriaxona IV 100 mg/kg/día c/12h + Ampicilina IV 300 mg/kg/día c/6h + Vancomicina IV 60 mg/kg/día c/6h.</p></div>
|
| 62 |
+
<div class="treatment-option border-orange-500"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p>Aztreonam IV 150 mg/kg/día c/6h + Vancomicina IV 60 mg/kg/día c/6h.</p></div>
|
| 63 |
+
</div>
|
| 64 |
+
<!-- Mayores -->
|
| 65 |
+
<div id="mayores" class="treatment-card">
|
| 66 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-child text-green-600"></i> Mayores de 3 meses</h2>
|
| 67 |
+
<h3 class="font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Etiología Frecuente</h3>
|
| 68 |
+
<div class="pathogen-list"><span class="pathogen-item">N. meningitidis</span><span class="pathogen-item">H. influenzae</span><span class="pathogen-item">S. pneumoniae</span></div>
|
| 69 |
+
<h3 class="font-semibold text-gray-700 mt-4 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h3>
|
| 70 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección</div><p>Cefotaxima IV 300 mg/kg/día c/6h <i>o</i> Ceftriaxona IV 100 mg/kg/día c/12h + Vancomicina IV 60 mg/kg/día c/6h.</p></div>
|
| 71 |
+
<div class="treatment-option border-orange-500"><div class="treatment-title"><i class="fas fa-allergies text-orange-500"></i> Alergia</div><p>Aztreonam IV 150 mg/kg/día c/6h + Vancomicina IV 60 mg/kg/día c/6h.</p></div>
|
| 72 |
+
</div>
|
| 73 |
+
<!-- Alergia -->
|
| 74 |
+
<div id="alergia" class="treatment-card">
|
| 75 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-allergies text-red-500"></i> Alergia a Beta-lactámicos</h2>
|
| 76 |
+
<div class="note-box"><div class="note-title"><i class="fas fa-info-circle"></i> Consideraciones</div>
|
| 77 |
+
<ul>
|
| 78 |
+
<li>Penicilinas/aminopenicilinas (tardía no grave): usar cefalosporinas no relacionadas + vancomicina.</li>
|
| 79 |
+
<li>Reacción grave (anafilaxia, urticaria): Aztreonam + vancomicina.</li>
|
| 80 |
+
<li>Reacción a cefalosporinas: Aztreonam + vancomicina.</li>
|
| 81 |
+
</ul>
|
| 82 |
+
</div>
|
| 83 |
+
</div>
|
| 84 |
+
<!-- Dexametasona -->
|
| 85 |
+
<div id="dexametasona" class="treatment-card">
|
| 86 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-pills text-yellow-600"></i> Uso de Dexametasona</h2>
|
| 87 |
+
<p class="text-gray-700"><strong>Dosis:</strong> 0.15 mg/kg IV c/6h (máx. 10 mg) durante 2-4 días.</p>
|
| 88 |
+
<p class="text-gray-700 mt-2">Administrar antes o con primer antibiótico. Indicado ≥6 semanas; suspender si se descarta Hib, neumococo o TBC.</p>
|
| 89 |
+
</div>
|
| 90 |
+
<!-- Duración -->
|
| 91 |
+
<div id="duracion" class="treatment-card">
|
| 92 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-clock text-gray-700"></i> Duración del Tratamiento</h2>
|
| 93 |
+
<ul class="text-gray-700">
|
| 94 |
+
<li>Neumococo: 10-14 días</li>
|
| 95 |
+
<li>Meningococo: 7 días</li>
|
| 96 |
+
<li>H. influenzae: 7-10 días</li>
|
| 97 |
+
<li>S. agalactiae: 14-21 días</li>
|
| 98 |
+
<li>Bacilos Gram-negativos: 14-21 días</li>
|
| 99 |
+
<li>Listeria monocytogenes: 21 días</li>
|
| 100 |
+
<li>S. aureus: mínimo 14 días</li>
|
| 101 |
+
</ul>
|
| 102 |
+
</div>
|
| 103 |
+
</div>
|
| 104 |
+
|
| 105 |
+
<script>
|
| 106 |
+
const sel = document.getElementById('selector');
|
| 107 |
+
const res = document.getElementById('result');
|
| 108 |
+
const storage = document.getElementById('guide-content');
|
| 109 |
+
sel.addEventListener('change', () => {
|
| 110 |
+
res.innerHTML = '';
|
| 111 |
+
const id = sel.value;
|
| 112 |
+
if (!id) return;
|
| 113 |
+
const node = storage.querySelector('#' + id);
|
| 114 |
+
if (node) res.appendChild(node.cloneNode(true));
|
| 115 |
+
});
|
| 116 |
+
</script>
|
| 117 |
+
|
| 118 |
+
<div class="mt-12 text-center text-sm text-gray-500">
|
| 119 |
+
<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
|
| 120 |
+
<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
|
| 121 |
+
</div>
|
| 122 |
+
</div>
|
| 123 |
+
</body>
|
| 124 |
+
</html>
|
proa/urologia_pediatrica.html
ADDED
|
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|
| 1 |
+
<!DOCTYPE html>
|
| 2 |
+
<html lang="es">
|
| 3 |
+
<head>
|
| 4 |
+
<meta charset="UTF-8">
|
| 5 |
+
<meta name="viewport" content="width=device-width, initial-scale=1.0">
|
| 6 |
+
<title>Guía PROA - Infecciones Tracto Urinario (Pediatría)</title>
|
| 7 |
+
<script src="https://cdn.tailwindcss.com"></script>
|
| 8 |
+
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
|
| 9 |
+
<style>
|
| 10 |
+
@import url('https://fonts.googleapis.com/css2?family=Montserrat:wght@300;400;500;600;700&display=swap');
|
| 11 |
+
body { font-family: 'Montserrat', sans-serif; background-color: #f8fafc; }
|
| 12 |
+
.treatment-card { transition: all 0.3s ease; }
|
| 13 |
+
.treatment-card:hover { transform: translateY(-2px); box-shadow: 0 10px 15px -3px rgba(0,0,0,0.1), 0 4px 6px -2px rgba(0,0,0,0.05); }
|
| 14 |
+
.pathogen-list { display: flex; flex-wrap: wrap; gap: 0.5rem; margin: 0.5rem 0; }
|
| 15 |
+
.pathogen-item { background-color: #e0f2fe; color: #0369a1; padding: 0.25rem 0.75rem; border-radius: 9999px; font-size: 0.875rem; font-weight: 500; }
|
| 16 |
+
.treatment-option { background-color: white; border-radius: 0.5rem; padding: 1rem; margin: 1rem 0 0.5rem 0; border-left: 4px solid #3b82f6; }
|
| 17 |
+
.treatment-title { font-weight: 600; color: #1e40af; margin-bottom: 0.5rem; display: flex; align-items: center; gap: 0.5rem; }
|
| 18 |
+
.note-box { background-color: #fffbeb; border-left: 4px solid #f59e0b; padding: 0.75rem; margin: 1rem 0; border-radius: 0 0.5rem 0.5rem 0; }
|
| 19 |
+
.note-title { font-weight: 600; color: #92400e; display: flex; align-items: center; gap: 0.5rem; margin-bottom: 0.5rem; }
|
| 20 |
+
.custom-select { background-image: url("data:image/svg+xml,%3csvg xmlns='http://www.w3.org/2000/svg' fill='none' viewBox='0 0 20 20'%3e%3cpath stroke='%236b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'/%3e%3c/svg%3e"); background-position: right 0.5rem center; background-repeat: no-repeat; background-size: 1.5em 1.5em; }
|
| 21 |
+
ul { list-style-position: outside; margin-left: 1.25rem; }
|
| 22 |
+
li { margin-bottom: 0.25rem; }
|
| 23 |
+
.sub-category { border-top: 1px dashed #cbd5e1; margin-top: 1.5rem; padding-top: 1.5rem; }
|
| 24 |
+
.sub-category-title { font-size: 1.25rem; font-weight: 600; color: #4b5563; margin-bottom: 1rem; }
|
| 25 |
+
</style>
|
| 26 |
+
</head>
|
| 27 |
+
<body class="min-h-screen bg-gray-50">
|
| 28 |
+
<div class="max-w-4xl mx-auto px-4 py-8">
|
| 29 |
+
<div class="flex items-center gap-3 mb-6">
|
| 30 |
+
<div class="bg-pink-500 p-2 rounded-lg text-white"><i class="fas fa-child text-2xl"></i></div>
|
| 31 |
+
<h1 class="text-3xl font-bold text-gray-800">Guía PROA - Infecciones Tracto Urinario (Pediatría)</h1>
|
| 32 |
+
</div>
|
| 33 |
+
<div class="bg-white rounded-xl shadow-md p-6 mb-6">
|
| 34 |
+
<label for="diagnosticSelector" class="block text-lg font-medium text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-arrow-down text-pink-500"></i> Tipo de Infección Urinaria</label>
|
| 35 |
+
<select id="diagnosticSelector" class="custom-select block w-full pl-3 pr-10 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
|
| 36 |
+
<option value="">-- Selecciona un tipo --</option>
|
| 37 |
+
<option value="cistitis_ped">Cistitis (ITU Baja)</option>
|
| 38 |
+
<option value="pielonefritis_ped">Pielonefritis Aguda (ITU Alta)</option>
|
| 39 |
+
</select>
|
| 40 |
+
</div>
|
| 41 |
+
<div id="result" class="space-y-6"></div>
|
| 42 |
+
|
| 43 |
+
<div id="guide-content-storage" class="hidden">
|
| 44 |
+
|
| 45 |
+
<div id="cistitis_ped" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
|
| 46 |
+
<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-bladder text-orange-500"></i> Cistitis (Infección Tracto Urinario Baja)</h2>
|
| 47 |
+
<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Escherichia coli (70-90%)</span><span class="pathogen-item">Klebsiella spp</span><span class="pathogen-item">Proteus mirabilis</span><span class="pathogen-item">Otras enterobacterias</span><span class="pathogen-item">Enterococcus faecalis</span></div></div>
|
| 48 |
+
|
| 49 |
+
<div class="sub-category">
|
| 50 |
+
<h3 class="sub-category-title"><i class="fas fa-baby text-purple-500 mr-2"></i>Niños Menores de 6 años</h3>
|
| 51 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico (VO)</h4>
|
| 52 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Opciones (Elegir una)</div><ul class="list-disc text-gray-700 space-y-1 ml-5"><li><strong>Cefuroxima:</strong> 7.5-15 mg/kg/dosis cada 12 horas VO.</li><li><strong>Amoxicilina-clavulánico:</strong> 40-50 mg/kg/día (dosis de amoxicilina) repartido cada 8 horas VO.</li><li><strong>Trimetoprim-sulfametoxazol (TMP/SMX):</strong> 2-3 mg/kg/dosis (dosis de trimetoprim) cada 12 horas VO. <span class="font-bold text-red-600">(NO usar en < 6 semanas de vida).</span></li></ul></div>
|
| 53 |
+
<div class="treatment-option border-green-500"><div class="treatment-title"><i class="far fa-calendar-alt text-green-600"></i> Duración</div><p class="text-gray-700">5-7 días.</p></div>
|
| 54 |
+
</div>
|
| 55 |
+
</div>
|
| 56 |
+
|
| 57 |
+
<div class="sub-category">
|
| 58 |
+
<h3 class="sub-category-title"><i class="fas fa-child text-teal-500 mr-2"></i>Niños de 6 años o Mayores</h3>
|
| 59 |
+
<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico (VO)</h4>
|
| 60 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-check-circle text-green-500"></i> De elección (Fosfomicina)</div><ul class="list-disc text-gray-700 space-y-1 ml-5"><li><strong>Niños 6-12 años:</strong> Fosfomicina-trometamol 1 sobre de 2 g VO dosis única.</li><li><strong>Niños >12 años:</strong> Fosfomicina-trometamol 1 sobre de 3 g VO dosis única.</li><li><span class="text-sm italic">Nota: Puede ser necesaria una segunda dosis separada 24 horas si persistencia.</span></li></ul></div>
|
| 61 |
+
<div class="treatment-option"><div class="treatment-title"><i class="fas fa-exchange-alt text-blue-500"></i> Alternativas</div><p class="text-gray-700">Cualquiera de los fármacos indicados para menores de 6 años (Cefuroxima, Amoxi-clav, TMP/SMX).</p></div>
|
| 62 |
+
<div class="treatment-option border-green-500"><div class="treatment-title"><i class="far fa-calendar-alt text-green-600"></i> Duración</div><ul class="list-disc text-gray-700 space-y-1 ml-5"><li><strong>Fosfomicina:</strong> Dosis única (o 2 dosis separadas 24h).</li><li><strong>Otros fármacos:</strong> 3-5 días.</li></ul></div>
|
| 63 |
+
</div>
|
| 64 |
+
</div>
|
| 65 |
+
|
| 66 |
+
<div class="note-box mt-6"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Generales Cistitis</div><ul class="list-disc text-gray-700 space-y-1"><li>No es necesario realizar urocultivo de control post-tratamiento si la respuesta clínica es adecuada.</li><li>Recordar la restricción de TMP/SMX en menores de 6 semanas.</li></ul></div>
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| 67 |
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</div>
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| 68 |
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<div id="pielonefritis_ped" class="treatment-card bg-white rounded-lg shadow-sm p-6 border border-gray-200">
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<h2 class="text-2xl font-bold text-gray-800 mb-4 flex items-center gap-2"><i class="fas fa-temperature-high text-red-600"></i> Pielonefritis Aguda (Infección Tracto Urinario Alta)</h2>
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| 71 |
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<div class="mb-6"><h3 class="text-lg font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-bug text-blue-500"></i> Agentes etiológicos Frecuentes</h3><div class="pathogen-list"><span class="pathogen-item">Escherichia coli (70-90%)</span><span class="pathogen-item">Klebsiella spp</span><span class="pathogen-item">Proteus mirabilis</span><span class="pathogen-item">Otras enterobacterias</span><span class="pathogen-item">Enterococcus faecalis</span></div></div>
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<div class="sub-category">
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<h3 class="sub-category-title"><i class="fas fa-clinic-medical mr-2"></i>Tratamiento Ambulatorio (Sin Ingreso)</h3>
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| 75 |
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<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico</h4>
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<div class="treatment-option"><div class="treatment-title"><i class="fas fa-pills text-blue-500"></i> Opción (VO)</div><p class="text-gray-700"><strong>Cefixima:</strong> 8 mg/kg cada 12 horas VO el primer día, luego continuar con 8 mg/kg cada 24 horas VO.</p></div>
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</div>
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</div>
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| 79 |
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<div class="sub-category">
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<h3 class="sub-category-title"><i class="fas fa-procedures text-red-700 mr-2"></i>Tratamiento con Ingreso Hospitalario</h3>
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<div class="mt-4"><h4 class="text-md font-semibold text-gray-700 mb-2 flex items-center gap-2"><i class="fas fa-prescription-bottle-alt text-blue-500"></i> Tratamiento Empírico (IV)</h4>
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<div class="treatment-option border-purple-500"><div class="treatment-title"><i class="fas fa-baby text-purple-600"></i> Menores de 3 meses</div><p class="text-gray-700 mb-1"><strong>De elección:</strong></p><ul class="list-disc text-gray-700 space-y-1 ml-5"><li>Ampicilina 25 mg/kg/dosis cada 6 horas IV <strong>+</strong> Gentamicina¹ 3-5 mg/kg/día cada 24 horas IV.</li></ul><p class="text-gray-700 mt-2 mb-1"><strong>Alternativa²:</strong></p><ul class="list-disc text-gray-700 space-y-1 ml-5"><li>Ampicilina 25 mg/kg/dosis cada 6 horas IV <strong>+</strong> Cefotaxima 100-150 mg/kg/día repartido cada 6-8 horas IV.</li></ul></div>
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| 84 |
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<div class="treatment-option border-teal-500"><div class="treatment-title"><i class="fas fa-child text-teal-600"></i> Mayores de 3 meses</div><p class="text-gray-700 mb-1"><strong>Opciones (Elegir una):</strong></p><ul class="list-disc text-gray-700 space-y-1 ml-5"><li><strong>Gentamicina¹:</strong> 5 mg/kg/día cada 24 horas IV.</li><li><strong>Cefotaxima:</strong> 150-200 mg/kg/día repartido cada 6-8 horas IV.</li><li><strong>Ceftriaxona:</strong> 50-75 mg/kg/día cada 12-24 horas IV.</li></ul></div>
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| 85 |
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</div>
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| 86 |
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</div>
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| 87 |
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<div class="note-box mt-6"><div class="note-title"><i class="fas fa-info-circle text-yellow-500"></i> Observaciones Generales Pielonefritis</div><ul class="list-disc text-gray-700 space-y-1"><li><strong>Duración total del tratamiento:</strong> 10 días.</li><li>Puede prolongarse a 2 semanas en lactantes pequeños o hasta 3 semanas si hay complicaciones o mala evolución.</li><li>En paciente hospitalizado: mantener antibioterapia parenteral hasta afebril, buen estado general y tolerancia oral adecuada, luego pasar a VO hasta completar duración total.</li><li>¹ Considerar Amikacina 20 mg/kg cada 24h IV en lugar de Gentamicina si existe riesgo de bacterias productoras de BLEE.</li><li>² Usar Alternativa (Ampicilina + Cefotaxima) en < 3 meses si: aspecto séptico, no descartada meningitis, insuficiencia renal o daño renal previo.</li><li>No es necesario realizar urocultivo de control post-tratamiento si la respuesta clínica es adecuada.</li></ul></div>
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</div>
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</div> <script>
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</script>
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<div class="mt-12 text-center text-sm text-gray-500">
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<p>Basado en: GUÍA DE TRATAMIENTO EMPÍRICO INFECCIONES TRACTO URINARIO EN PEDIATRÍA PC-21_AL(E)A-EP Rev. A (16/10/2023)</p>
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<p>© 2025 Grupo PROA del Hospital de Alcañiz</p>
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<p>Elaborado por Dr. Antonio J. Arnal Meinhardt | Médico de Urgencias</p>
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<p class="mt-1 text-xs">Autores Guía Original: Estela Soro Ferrer, Ana Revuelta Cabello, Nuria Clavero Montañés, Laura Ochoa Gómez, Claudia Orden Rueda, Andrea Pinilla Rello, Eva Queipo.</p>
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