Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right mid-to - lower lung opacity again seen , decreased as compared to the prior study . Again worrisome for infectious process . There also appears to be bilateral pleural effusions , right greater than left . The cardiac silhouette remains quite enlarged . The aorta is tortuous .
    OUTPUT:
    
Marked enlargement of the cardiac silhouette . Right mid - to - lower lung zone and left lower lung zone opacities again seen , decreased on the right as compared to the prior , still concerning for infectious process . Likely small - to - moderate pleural effusion on the right and small pleural effusion on the left .