What are diffuse infiltrates on neonate xray? acute infection or rds?

Can be either: In a neonate , depending on circumstances it can be either. If baby is having respiratory distress and a follow up chest X-ray shows increasing ground glass appearance it is likely RDS. Also perinatal history is helpful - whether there was prematurity or premature rupture of membranes. Most times because the baby is small and having distress baby is treated for both with close follow ups.