A recent case report of lung illness in a teenager details another type of lung disease that may occur in people who use e-cigarettes: necrotizing pneumonia.

Necrotizing pneumonia is an uncommon complication of pneumonia. It destroys areas of lung tissue, and can occur even if someone has been treated with antibiotics, according to a previous review in Biomed Central.

“It’s pretty unusual for a generally healthy person to get an invasive pneumonia like this, but not impossible,” said Dr. Ravi Kalhan, a professor of medicine and preventive medicine in the division of pulmonary and critical care medicine at Northwestern Feinberg School of Medicine in Chicago. Kalhan was not involved in the current case, but is familiar with the new report.