Peripheral nervous system involvement in Q fever

Q fever is a zoonosis with a worldwide distribution caused by Coxiella burneti. Acute manifestations include a self-limited febrile illness which may associate headache, atypical pneumonia, or hepatitis. Neurological manifestations are rare, and they occur in less than half of the patients. Of these, approximately 1% present peripheral nervous system involvement, and, when present, it is difficult to diagnose because it has multiple manifestations such as mononeuritis multiplex, plexopathy or Guillain Barre syndrome. Due to the high rate of neurological sequelae, early diagnostic suspicion and appropriate treatment must be established. In this review, we have collected the patients with peripheral nervous system involvement due to Coxiella burnetii described so far. Our aim is to provide a concise description of the disease, its diagnosis and management that may be useful to clinicians treating such patients.