Coxiella burnetii: The 'query' fever bacterium - A model of immune subversion by a strictly intracellular microorganism

Although substantial progress occurred in the knowledge of Coxiella burnetii during the past years, the pathophysiology of Q fever is still obscure. Emerging evidence from clinical investigations suggested that certain disorders of cell-mediated immunity play a pivotal role in Q fever and especially in its chronic form. This review analyses the potential stategies that C. burnetii, a strictly intracellular pathogen, use to divert microbicidal mechanisms of macrophages and to depress protective T-cell mediated immunity. The role of monocytes in the induction of Q fever is specifically discussed.