Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are small - to - moderate bilateral pleural effusions with overlying atelectasis . There are multiple areas of opacity in the lungs involving the bilateral upper lobes , right greater than left ; right middle lobe and lingula , as well as the lower lobes . While findings may be due to severe multifocal infection , other etiologies such as metastatic disease should be considered and needs to be excluded . The aortic knob is calcified . The cardiac silhouette size is grossly stable as compared to the prior study . There is no pneumothorax .
    OUTPUT:
    
Small - to - moderate bilateral pleural effusions . Extensive multifocal opacities bilaterally , as above , concerning for severe multifocal infection , however , recommend followup to resolution as underlying metastatic disease / malignancy should be excluded .