Approach

Coxiella burnetii infection is a notifiable disease in the US; however, reporting is not required in many other countries.

Most people infected with C burnetii remain asymptomatic. For those with symptoms, more than 30 different clinical syndromes have been described.

Diagnosis requires a high level of suspicion in a febrile patient who presents with non-specific symptoms. Recent contact with parturient animals is very rarely reported. Most laboratories do not culture C burnetii, because it is technically difficult. Culturing C burnetii requires a biosafety level 3 containment, because of the organism's significant infectivity and potential for use as a weapon of bioterrorism.[2][48] Therefore, diagnosis relies on serological analysis. Polymerase chain reaction (PCR) may be used for diagnosis of acute infection; however, it is not always readily available.

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