Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again noted are scattered parenchymal opacities consistent with known multifocal pneumonia . There is also an element of vascular congestion . Bilateral pleural effusions are appreciated and are small in size . Heart remains enlarged . A right - sided PICC line is in place . The internal jugular central venous line has been removed . There is no pneumothorax .
    OUTPUT:
    
Findings consistent with multi focal pneumonia and superimposed mild vascular congestion . Overall the findings are not significantly changed .