The quantum Kepler-Coulomb system in three dimensions is well known to be second order superintegrable, with a symmetry algebra that closes polynomially under commutators. This polynomial closure is also typical for second order superintegrable systems in 2D and for second order systems in 3D with nondegenerate (four-parameter) potentials. However, the degenerate three-parameter potential for the 3D Kepler-Coulomb system (also second order superintegrable) is an exception, as its symmetry algebra does not close polynomially. The 3D four-parameter potential for the extended Kepler-Coulomb system is not even second order superintegrable, but Verrier and Evans (2008 J. Math. Phys. 49 022902) showed it was fourth order superintegrable, and Tanoudis and Daskaloyannis (2011 arXiv:11020397v1) showed that, if a second fourth order symmetry is added to the generators, the symmetry algebra closes polynomially. Here, based on the Tremblay, Turbiner and Winternitz construction, we consider an infinite class of quantum extended Kepler-Coulomb three-and four-parameter systems indexed by a pair of rational numbers (k(1), k(2)) and reducing to the usual systems when k(1) = k(2) = 1. We show these systems to be superintegrable of arbitrarily high order and determine the structure of their symmetry algebras. We demonstrate that the symmetry algebras close algebraically; only for systems admitting extra discrete symmetries is polynomial closure achieved. Underlying the structure theory is the existence of raising and lowering operators, not themselves symmetry operators or even defined independent of basis, that can be employed to construct the symmetry operators and their structure relations.