FINDINGS:
Compared with , there is a new moderate to large left pleural
 effusion and basilar atelectasis, underlying consolidation is difficult to
 exclude.  There is a small right pleural effusion.    No pneumothorax is seen.
 Cardiomediastinal silhouette is unchanged.  A left chest wall pacemaker
 defibrillator is present with leads terminating in the right atrium, right
 ventricle, and coronary sinus.

IMPRESSION:
Moderate to large left pleural effusion and bibasilar atelectasis,underlying
 consolidation difficult to exclude.  Small right pleural effusion.