Complications

Complication
Timeframe
Likelihood
long term
low

An increasingly important complication of acute C burnetii infection leading to long-term disability; however, it is unclear how this complication develops.[59][60][61]

Occurs in approximately 20% of patients.[59][60] 

Presents approximately 6 months after presentation of acute infection.

Cognitive behavioural therapy has been shown to reduce fatigue severity.[62]

Chronic fatigue syndrome

variable
high

Endocarditis is the most frequent persistent infection (up to 70% of cases).[2]

Symptoms can recur after antimicrobial therapy is discontinued, so therapy is recommended long term (at least 18 months).

Severe heart failure is a recognised potential complication of endocarditis.

Infective endocarditis

variable
high

Spores can reactivate during pregnancy, eliciting several complications, including spontaneous abortion, fetal death, and fetal malformation.[4][46]

Obstetricians must be vigilant for signs of disease in patients who have previously had Coxiella burnetii infection.

variable
high

C burnetii infection acquired during the first trimester of pregnancy can result in spontaneous abortion, fetal death, fetal malformation, growth retardation, oligohydramnios, or premature delivery.[4][46][108]

Miscarriage

variable
low

Neurological sequelae can manifest after patients recover from acute infection.

Residual neurological impairment can manifest as weakness, recurrent meningismus, blurred vision, residual paraesthesias, and sensory loss.

Other complications include behavioural changes, cerebellar signs and symptoms, cranial nerve palsies, extrapyramidal disease, and Miller-Fisher syndrome, a variant of Guillain-Barré syndrome.

Demyelinating polyradiculoneuritis has been reported after recovery from pneumonia.[1]

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