IMPRESSION:
Port-A-Cath catheter tip is at the cavoatrial junction. Cardiac silhouette
 appears to be enlarged as compared to the prior study might potentially be
 related to the sickle cell crisis. New opacities are noted in the lower lobes
 as well as vascular enlargement. No clear pneumonia is seen but right lower
 lobe pneumonia cannot be excluded or potentially pulmonary infarct. No large
 pleural effusion is seen but small pleural effusion is most likely present