Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is mildly enlarged . A prosthetic mitral valve is noted . Midline sternal wires are well aligned and intact . Surgical clips are seen in the lower neck . A right - sided catheter is again seen , with the tip terminating in the lower SVC . The right middle lobe opacity which was seen on recent comparisons appears progressed and more confluent than on prior examinations . Bibasilar opacities have remained stable . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
Worsening right middle lobe opacity and persistent bibasilar opacities most consistent with multifocal pneumonia , with a component of coexisting atelectasis in the right middle lobe .