The December tsunami that left over 200,000 people dead or missing in Asia and Africa appears to have caused some unusual lung and sinus infections, and even a paralyzing brain infection, according to officials and a report in the New England Journal of Medicine.

Doctors from Massachusetts General Hospital report in the Journal on the case of a 17-year-old girl from Indonesia who was 2.5 kilometers inland when a wave from the Dec. 26 tsunami swept her up and carried her another kilometer.

Two days later she developed a cough, followed by headache, nausea and vomiting.

She was treated for pneumonia but after another week developed a weakness on the right side of her body, which progressed to paralysis.

The teen turned out to have a brain abscess caused by the same infection that had first attacked her lungs. After intensive treatment with antibiotics, she recovered and was able to walk.

Her case was rare among tsunami survivors, said Tjandra Yoga Aditama, a senior lung doctor who served in a government team that reopened hospitals in Aceh where the tsunami left more than 160,000 killed or missing.

“There were a few cases, but definitely not many. We had one treated in Aceh and several (treated) in Medan,” he said, referring to the country’s third largest city where many tsunami patients from Aceh were taken.

Aditama said he had not heard of any new cases since early this year, but added that pneumonia was a major problem for tsunami survivors.

U.N. World Health Organization (WHO) officials also said the case reported in the journal was likely to be rare.

In Thailand, a team of doctors at Bangkok’s Rajavithi hospital reported that after the Dec. 26 disaster they had to treat lung problems in dozens of patients who inhaled salt water contaminated by bacteria often found in the soil.

A few patients went on to develop severe pneumonia, according to the group, led by Subsai Kongsaengdao.

All had to be treated with antibiotics.

In another Bangkok hospital, doctors discovered the case of a 35-year-old man who had also inhaled seawater, but whose infection had produced a large amount of green-colored purulent material” and sand packed into his sinuses.

Doctors, after rinsing out his sinuses, uncovered five types of bacteria present. He recovered with antibiotic therapy.