{
  "abstract": "Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is associated with high mortality and diagnostic difficulties. We report a fatal case of CAPA with a distinctive cobblestone-like tracheobronchial appearance observed during bronchoscopy. A patient receiving maintenance hemodialysis for chronic kidney disease was admitted with severe COVID-19. Bronchoscopy revealed multiple white tracheobronchial plaques, suggestive of an invasive Aspergillus infection. Despite antifungal therapy, respiratory failure progressed, and repeat bronchoscopy revealed worsening cobblestone-like lesions. The patient died despite receiving intensive treatment. Autopsy confirmed Aspergillus hyphal invasion, corresponding to the bronchoscopic findings, highlighting a rare but diagnostically important airway manifestation of CAPA.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Toshihide Ishida"
    },
    {
      "name": "Nobuhiro Fujishima"
    },
    {
      "name": "Yoshio Satonaga"
    },
    {
      "name": "Marimu Yamanaka"
    },
    {
      "name": "Shota Omori"
    },
    {
      "name": "Ryuichi Takenaka"
    },
    {
      "name": "Ryuzo Abe"
    },
    {
      "name": "Kazuhiro Kawamura"
    },
    {
      "name": "Tsutomu Daa"
    },
    {
      "name": "Kosaku Komiya"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/72rx1jtdyp133.bib",
  "cited_by": 0,
  "doi": "10.2169/internalmedicine.7958-26",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7958-26/_article",
  "id": "72rx1jtdyp133",
  "issns": [
    "1349-7235",
    "0918-2918"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7958-26/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/general"
    ],
    [
      "openalex",
      "2725|Antifungal resistance and susceptibility"
    ]
  ],
  "openalex": "W7221773833",
  "pdf_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7958-26/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/72rx1jtdyp133.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.2169/internalmedicine.7958-26",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7958-26/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Antifungal resistance and susceptibility",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Dynamic Bronchoscopic Evolution of a Cobblestone-like Appearance in COVID-19-associated Pulmonary Aspergillosis: A Case Report",
  "title_text": "Dynamic Bronchoscopic Evolution of a Cobblestone-like Appearance in COVID-19-associated Pulmonary Aspergillosis: A Case Report",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/72rx1jtdyp133",
  "venue": "Internal Medicine",
  "versions": []
}