Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours are normal . Diffuse , bilateral symmetric airspace opacities have progressed significantly compared to the previous exam . No pleural effusion or pneumothorax is seen . No pulmonary vascular congestion is present . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
Worsening diffuse bilateral airspace opacities concerning for multifocal pneumonia including pneumocystis .