Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: This is a rotated film with the patient leaning towards the right . There is a right - sided effusion layering laterally . This is likely increased compared to prior , but absolute changes are difficult to assess due to change in position . There is dense retrocardiac opacity compatible with volume loss / infiltrate / effusion involving the left lower lung . Please note that a left chest tube is in place ; however , the port of the chest tube is projecting outside the chest wall . There is mild pulmonary vascular re-distribution and some hazy alveolar infiltrates affecting the upper lobes .
    OUTPUT:
    
Fluid overload . An underlying infectious infiltrate can not be excluded . The chest tube is not optimally positioned .