Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to most recent radiograph , there is more confluent appearance of previously seen right middle and lower lobe opacity , concerning for infectious pneumonia . Right pleural effusion is likely increased since prior exam . The left lung is grossly clear . Otherwise the exam is unchanged . Sternotomy wires and surgical clips are again noted to be intact .
    OUTPUT:
    
Worsening right middle and lower lobes pneumonia . Increased right pleural effusion .