Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided PICC tip terminates at the junction of the SVC and right atrium . Heart size appears top normal . The mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . Patchy ill - defined nodular opacities in both lower lobes appear progressed in the interval concerning for worsening bronchiolitis . Other additional patchy areas of focal ill - defined opacity in the upper lobes bilaterally appear minimally improved . No pleural effusion or pneumothorax is present . No acute osseous abnormality is seen .
    OUTPUT:
    
Increased ill - defined patchy nodular opacities in both lung bases concerning for worsening infectious bronchiolitis . Other additional focal patchy opacities in the upper lobes bilaterally thought to reflect additional sites of small airways disease appear minimally improved .