IMPRESSION:
Cart focal is substantial.  Mediastinal silhouette is stable.  Pulmonary edema
 has developed in the interim, extensive.  It obscures previously seen
 asymmetric left suprahilar opacity that might reflect infectious process.
 
 RECOMMENDATION(S):  Reassessment of the patient after diuresis is recommended.
 
 Followup of the left lung opacity concerning for infection is recommended.
 
 Right pleural effusion is large and unchanged.