Wormhearted Suffragan

Medium undead, chaotic evil

Armor Class 12
Hit Points 97 (13d8 + 39)
Speed 30 ft.

10 (+0) 14 (+2) 16 (+3) 11 (+0) 16 (+3) 8 (-1)

Skills Medicine +6, Religion +3
Damage Resistances necrotic; bludgeoning, piercing, and slashing from nonmagical weapons
Damage Vulnerabilities radiant
Senses darkvision 60 ft., passive Perception 13
Languages the languages it knew in life
Challenge 5 (1,800 XP)

Special Traits


  • Multiattack. The wormhearted suffragan can make two helminth infestation attacks, or it can cast one spell and make one helminth infestation attack.
  • Helminth Infestation. Melee Weapon Attack: +5 to hit, reach 5 ft., one target. Hit: 7 (2d6) bludgeoning damage plus 10 (3d6) necrotic damage. If the target is a creature, it must succeed on a DC 14 Constitution saving throw or be afflicted with a helminth infestation (parasitic worms). An afflicted creature can’t regain hit points and its hit point maximum decreases by 10 (3d6) for every 24 hours that elapse. If the affliction reduces the target’s hit point maximum to 0, the victim dies. The affliction lasts until removed by any magic that cures disease.
  • Ingest Weapons. When the xanka is hit by a melee weapon and the final, adjusted attack roll is 19 or less, the weapon gains a permanent -1 penalty to damage rolls, after inflicting damage for this attack. If the penalty reaches -5, the weapon is destroyed. Even magic weapons are subject to this effect.
  • Magic Weapons. The xanka’s weapon attacks are magical.


  • Absorb. Melee Weapon Attack: +4 to hit, reach 5 ft., one target. Hit: 6 (1d8 + 2) force damage, and the xanka regains hit points equal to the damage caused by its attack. In addition, a living creature hit by this attack must make a successful DC 12 Dexterity saving throw or suffer a gaping wound that causes 2 (1d4) necrotic damage at the end of each of the creature’s turns until the wound is treated with magical healing or with a successful DC 10 Intelligence (Medicine) check. If a creature who fails this saving throw is wearing armor or using a shield, the creature can choose to prevent the necrotic damage by permanently reducing the AC of its armor or shield by 1 instead.


This humanoid wears robes to hide its corpselike pallor and lifeless gray hair. Fine, arm-length worms wriggle through abscesses in its flesh and its empty eye-sockets. It moves stooped over, with a shuffling gait, belying its speed and agility.


Wormhearted suffragans are devoted followers of the Demon Lord of the Devouring Worm, demon lord of worms, who they believe is the servant and forerunner of a dark goddess of worms and decay.

Dark Worm Hearts. Formerly, the suffragans were priests or holy officers of other faiths, but their hearts were corrupted by their fear and loathing. Once pledged to the service of the devouring worm, the Demon Lord of the Devouring Worm replaced their hearts with a bulbous, writhing conglomeration of worms, which permits them to carry on with an undead mockery of life.

Prey on the Wounded. They frequent graveyards, casting detect evil or speak with dead to learn who was truly cruel and duplicitous in life. They also follow armies, visiting battlefields shortly after the fighting is over. In the guise of nurses or chirurgeons, they select their targets from among the dead and dying for as long as they remain undetected. In both cases, they cast animate dead to provide the worm goddess with viable skeletal or zombie servants.

Fear Light and Radiance. Wormhearted suffragans have a weakness; they are especially susceptible to the flesh-searing power of radiant magic, and for this reason avoid priests of the sun god or gods of light. At night, however, they are a walking contagion, infesting their enemies with parasitic worms that devour victims from within. Their favorite tactic is to cast hold person, attack with a helminth infestation, then animate their slain enemies into unlife.

Section 15: Copyright Notice

Tome of Beasts. Copyright 2016, Open Design; Authors Chris Harris, Dan Dillon, Rodrigo Garcia Carmona, and Wolfgang Baur.