FINDINGS:
Portable upright chest radiograph was obtained.  The lungs are well
 expanded.  Left basal opacity has progressed and could reflect a focus of
 aspiration or pneumonia.  Additional focal opacities in the lateral right mid
 lung and medial right lower lung could reflect additional sites of infection
 or aspiration.  Interstitial prominence is greater than on the prior and a
 component of pulmonary edema superimposed upon existing chronic lung disease
 is suspected.  No pneumothorax is seen with perhaps trace bilateral pleural
 effusions.  Cardiomediastinal contours are unchanged.

IMPRESSION:
Likely multifocal pneumonia, either aspiration or infectious, with
 presumed pulmonary edema superimposed on a background of chronic lung disease.