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Review
. 2025 Dec;16(1):2495842.
doi: 10.1080/21505594.2025.2495842. Epub 2025 Jun 19.

Pathogenicity and Virulence of Coxiella burnetii: Focus on Q fever

Soraya Mezouar  1   2 , Benoit Desnues  3   4 , Yassina Bechah  3   4 , Nathalie Bardin  5 , Christian Devaux  3   4   6 , Jean-Louis Mege  1   7
Affiliations
Review

Pathogenicity and Virulence of Coxiella burnetii: Focus on Q fever

Soraya Mezouar et al. Virulence. 2025 Dec.

Abstract

Coxiella burnetii is responsible for Q fever, a zoonosis that mainly manifests as a mild acute infection and may persist in specific individuals causing severe complications, including endocarditis and vascular infections. Transmission mainly occurs through the inhalation of aerosols, underlining bacterial resistance to environmental stress. C. burnetii is an intracellular gram-negative pathogen that can infect and survive in monocytes and macrophages and replicate within acidic compartments. C. burnetii expresses several virulence factors, including lipopolysaccharide and a type IV secretion system, which are involved in hijacking several functions of the immune system and controlling cell death. This review summarizes research on C. burnetii infection from clinical presentation of Q fever to bacterial and host factors of virulence. It compiles immunological data associated with bacterial cure or persistence and discusses a potential link between C. burnetii-macrophage interaction and immune dysregulation of Q fever.

Keywords: Coxiella burnetii; Q fever; macrophages; virulence factors.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Landmark events related to Q fever and relevant PubMed publication.
Figure 2.
Figure 2.
Clinical characteristics of Q fever in humans.
Figure 3.
Figure 3.
C. burnetii infection and replication in macrophages.
Figure 4.
Figure 4.
Recovery and chronic/persistent infection against C. burnetii.
See this image and copyright information in PMC

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