ABSTRACTCentral to Q fever pathogenesis is replication of the causative agent,Coxiella burnetii, within a phagolysosome-like parasitophorous vacuole (PV) in mononuclear phagocytes.C. burnetiimodulates PV biogenesis and other host cell functions, such as apoptotic signaling, presumably via the activity of proteins delivered to the host cytosol by a Dot/Icm type IVB secretion system (T4BSS). In this study, we utilized aC. burnetiistrain carrying IcmD inactivated by theHimar1transposon to investigate the requirements for Dot/Icm function inC. burnetiiparasitism of human THP-1 macrophage-like cells. TheicmD::Tn mutant failed to secrete characterized T4BSS substrates, a defect that correlated with deficient replication, PV development, and apoptosis protection. Restoration of type IVB secretion and intracellular growth of theicmD::Tn mutant required complementation withicmD,-J, and-B, indicating a polar effect of the transposon insertion on downstreamdot/icmgenes. Induction oficmDJBexpression at 1 day postinfection resulted inC. burnetiireplication and PV generation. Collectively, these data prove that T4BSS function is required for productive infection of human macrophages byC. burnetii. However, illustrating the metabolic flexibility ofC.burnetti, theicmD::Tn mutant could replicate intracellularly when sequestered in a PV generated by wild-type bacteria, where Dot/Icm function is provided intrans, and within a phenotypically similar PV generated by the protozoan parasiteLeishmania amazonensis, where host cells are devoid of Dot/Icm T4BSS effector proteins.IMPORTANCECoxiella burnetii, the cause of human Q fever, is the only bacterial pathogen known to replicate in a vacuole resembling a phagolysosome. The organism manipulates host macrophages to promote the biogenesis of a vacuolar compartment permissive for growth. By analogy to the well-established cellular microbiology ofLegionella pneumophila, the Dot/Icm type IVB secretion system ofC. burnetiiis implicated as a critical virulence factor in host cell modification that delivers proteins with effector functions directly into the host cell cytosol. Using new genetic tools, we verify that Dot/Icm function is essential for productive infection of human macrophages byC. burnetii. Interestingly, despite the production of homologous secretion systems,L. pneumophilaandC. burnetiihave strikingly different temporal requirements for Dot/Icm function during their respective infectious cycles.