How to handle Kyuss Worm infection in PF2?

Age of Worms Adventure Path

Hi everyone,

I'm running a PF2 dirty conversion of the Age of Worms campaign. So far it's been a ton of fun and everyone is enjoying the gritty dark story! We are in Chapter 3, Encounter at Blackwall Keep, and I need to figure out how to handle worm / spawn infestations in players. In the original game, once a worm reaches your brain you take INT damage every round until you die. The only way to stop this damage is to cure the player via specific spells or a heal check to rip out the worm.

PF2 no longer has ability damage, so I need to rewrite the infection. What would be the best PF2 mechanic to use to mimic the old worm effects? I need something that marches the player inexorably toward death within an encounter phase...

I figure that I can substitute the basic INT damage effects by afflicting the player with the Stupefied condition each round, and perhaps some poison damage but poison damage can be healed back up. Would it work to create a unique Poison track that simply ends in death at its final stage? I don't love this idea because Poison tracks allow the infected player a chance to cure himself thru successful saves each round, and the worms in the original don't work that way. I'm a bit stumped! All suggestions are welcome!

Sovereign Court

Pathfinder Roleplaying Game Charter Superscriber; Pathfinder Starfinder Adventure Path, Starfinder Roleplaying Game, Starfinder Society Subscriber

I'd go with higher levels of the Stupefied condition.

Critical Failure = Stupefied level + 4 (and perhaps Doomed +1)
Failure = Stupefied level + 2
Success = Stupefied level + 1
Critical Success = Stupefied level stays

Cure: 2 successful critical successes?

As long as the Kyuss worm runs rampant in your body, the Stupefied condition does not go down automatically.

Once the level of Stupefied reaches half your INT (rounded up), each failure and critical failure adds one level of the Doomed condition. That will make players very uncomfortable.

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Thanks for your suggestions! DOOMED is a really great idea. I decided not to use it in the primary infection since a Kyuss Worm in the brain gets worse very quickly (each round) and is more combat focused, but I did find another place for it!

There are multiple Kyuss Worm infections in the campaign. So far in Chapter 3 we get introduced to three. Here is how I ended up adapting everything. I thought it might be useful for someone in the future! Note that the saving throw DC values were generated for Level 5-6 play range and should be adjusted to meet your level needs.

EDITED to hide all the details behind a spoiler.

Kyuss Worm infections:

Slow Worm
Players get infected by slow worms when drinking a potion that has a worm inside. This infection is automatic and sneaky but can also be easily cured. Victims are simply DOOMED until they die from DOOMED reaching its maximum threshold.

* Drinking the potion = Perception (secret) DC 25 (expert, very hard) to notice you swallowed something unexpected.
* Automatic infection (no save), with a 1 day onset
* Slow Worm (disease) There is no initial saving throw, this disease is caught automatically. Doomed cannot be removed or reduced until the disease is cured. SAVING THROW DC 18 Fortitude; Onset 1 day; STAGE 1 Doomed 1 (1 day); STAGE 2 Doomed 2 (1 day); Stage 3 Doomed 3 (1 day); Stage 4 Doomed 4 (1 day); Stage 5 death, and rise as a Kyuss Spawn after 1d6+4 rounds

Kyuss' Gift
Spawn of Kyuss pass this affliction along whenever they hit someone. This supernatural disease manifests as rotting flesh and dementia.

Kyuss' Gift (disease) After the onset period, Healing magic has only half effect on the victim until the disease is cured. SAVING THROW DC 20 Fortitude; Onset 1 day; Stage 1 drained 1 (1 day); Stage 2 drained 2 and stupefied 2 (1 day); Stage 3 drained 3 and stupefied 3 (1 day)

Spawn of Kyuss - Worm Attack - the scariest one
* When a Spawn of Kyuss hits with its slam attack, a worm is automatically transferred to its victim. If the victim hits a Spawn of Kyuss with a touch spell or an unarmed attack or similar natural weapon, 1d4 worms are automatically transferred.
* This Spawn's worms acts automatically on the Spawn of Kyuss' next turn.
* A worm gets 1 action on its turn, and will first burrow automatically under the victim's skin, dealing 1 piercing damage. This action fails if the victim can fully resist the piercing (such as Barkskin).
* Once inside, roll 1d4+1. This is the # of rounds that it will take before the worm reaches the victim's brain.
* On subsequent rounds, the worm deals 1 piercing damage until it reaches the brain.
* Players can stop the worm in a few ways:
* * Attack it directly and kill it before it gets under the skin (10AC, 1hp)
* * DC 20 Treat Poison (Medicine) check to pull it out of the skin (can be tried again next round if failed)
* * Cast Neutralize Poison to kill all worms both on and in the body
* * Deal cold damage to the victim to stun all worms both on and in the body for 1 round.

* Once a worm reaches the brain, the player is automatically infected with Stage 1 of the final, deadly affliction.
* Neutralize Poison can no longer stop the infection, but can delay it for 10d6 minutes.
* Kyuss Brain Worm (disease, virulent) This disease cannot be cured by saving alone. Other means like Remove Disease spells or Medicine checks are required. SAVING THROW DC 22 Fortitude; STAGE 1 stupefied 2 (1 round); STAGE 2 stupefied 2 and when you take damage make a Will Save (disease's DC) or become confused (1 round); STAGE 3 stupefied 3 and when you take damage make a Will Save (disease's DC) or become confused (1 round); STAGE 4 stupefied 4, confused, and damage doesn't end confusion (1 round); STAGE 5 4d10 poison damage and unconscious (10 minutes); STAGE 6 death, and rise as a Spawn of Kyuss after 1d6+4 rounds

Hello there. Can you send me your conversion of age of worms in private message? Thanx

Hi shadowblade123! I can't seem to figure out how to do private messages, sorry :D I'm rather new to the paizo forums.

I haven't written down all my conversions into PF2, but I could start! Can you PM me maybe?

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