Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A right pleural effusion is moderate in size with fluid tracking into the minor fissure . Extensive , bilateral diffuse , ill - defined airspace opacities have developed in the interim , consistent with multifocal pneumonia . New left pleural effusion , if present is small . Extensive aortic knob calcifications are unchanged . Single lead left cardiac pacer device is unchanged . The mediastinal contours are unchanged . The heart remains enlarged .
    OUTPUT:
    
1 . Severe multifocal pneumonia . 2 . Persistent moderate right pleural effusion .