Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate right pneumothorax has increased in size compared to prior . The 2 right - sided chest tubes are again seen . The tracheostomy in below fragments are again visualized . Left chest tube is in place . There has been interval increase in the left pleural effusion . There is also increased left lower lobe volume loss with dense retrocardiac opacity there is also volume loss in the right lower lobe . An underlying infectious infiltrate in either lower lobe can not be excluded
    OUTPUT:
    
Worsening appearance to the lungs with increased pneumothorax on the right and increased effusion on the left