What is a characteristic feature of congenital cytomegalovirus infection?

A prominent feature of congenital cytomegalovirus (CMV) infection is the presence of inclusion bodies in infected cells. These inclusion bodies are typically large, intranuclear, and occur within the cytoplasm of the infected cells, resembling "owl-eye" appearance due to their size and morphology. This histopathological finding can be detected in various tissues and is crucial for diagnosis, particularly in cases of congenital infection where early identification can impact management and outcomes.

In contrast, severe dysplastic skin lesions are associated with other congenital infections, such as zika virus or infections like herpes simplex virus. Multiple organ system involvement is characteristic of congenital infections, but CMV is notable for its impact on the central nervous system (CNS), leading to conditions such as microcephaly or sensorineural hearing loss. Acute respiratory distress syndrome, while a serious condition, is not specifically linked as a hallmark of congenital CMV. Therefore, observing inclusion bodies serves as a key diagnostic indicator of congenital CMV infection, making it the correct option in this scenario.