| Hit Dice: | 16d12 (104 hp) |
| Initiative: | −1 |
| Speed: | 40 ft. (8 squares) |
| Armor Class: | 23 (−2 size, −1 Dex, +16 natural), touch 7, flat-footed 23 |
| Base Attack/Grapple: | +8/+26 |
| Attack: | Slam +16 melee (1d8+10 plus plague) |
| Full Attack: | 2 slams +16 melee (1d8+10 plus plague) |
| Space/Reach: | 15 ft./15 ft. |
| Special Attacks: | Plague, vomit rat swarm |
| Special Qualities: | Damage reduction 10/slashing, darkvision 60 ft., undead traits |
| Saves: | Fort +5, Ref +4, Will +11 |
| Abilities: | Str 31, Dex 9, Con —, Int —, Wis 12, Cha 16 |
| Skills: | — |
| Feats: | — |
| Environment: | Underground |
| Organization: | Solitary or pair plus 2d4 rat swarms |
| Challenge Rating: | 10 |
| Treasure: | Standard |
| Alignment: | Always neutral evil |
| Advancement: | 17–32 HD (Huge); 33–48 HD (Gargantuan) ♊ |
| Level Adjustment: | — |
Myriad lumps move just under the skin of this huge, gruesome, humanoid-shaped creature. Its bloodless complexion resembles a corpse.
These mindless undead creatures lumber about, seeking to kill any living creature except for rats and vermin. If one finds its way into civilization it, and the rat swarms it brings, can deplete the population of a town.
A plague spewer’s greatest threat is the devastating disease it carries. Unlike many such ailments, this one spreads merely from contact. Thus, those seeking to help the afflicted often become victims themselves. Plague spewers stand 22 feet tall and weigh 10 tons.
Plague spewers hate almost all living creatures and will launch themselves into combat, relentlessly attacking the nearest foe. Plague spewers attack without cunning or guile. They seek to slam and bash living creatures. Periodically, and whenever they cannot easily reach a foe, they vomit forth swarms of rats.
Plague (Su): Supernatural disease—slam, Fortitude DC 21, incubation period 1 minute; damage 2d4 Dex and 2d4 Con. The save DC is Charisma-based. The disease is spread by contact and does not require injury.
Unlike normal diseases, plague continues until the victim reaches Constitution 0 (and dies) or until a remove disease spell or similar magic (see Disease) is applied.
An afflicted creature of Huge size or larger who dies of the plague rises as a plague spewer in 1d4 days.
Vomit Rat Swarm (Su): As a full-round action, a plague spewer can spew forth a rat swarm. It can do this up to four times per day.
At least one plague spewer haunts the dungeons below Sharn, and others are known to inhabit the Mournland as well as some of the ancient Dhakaani ruins that dot the landscape of Khorvaire. However, plague spewers are most commonly encountered on Xen’drik, where they are rumored to be the undead remains of giants whom the great dragons of Argonnessen cursed with a foul plague.
Plague spewers have infested cities such as Westgate, Marsember, and Urmlaspyr with their rat swarms. The fact that almost all plague spewers have been encountered along the Dragon Coast has fueled rumors of a “plague cult.” Although adventurers in Westgate and Urmlaspyr have helped local constabularies deal with the unprecedented rat populations in those cities by finding and destroying the plague spewers responsible, attempts to locate a plague spewer beneath the streets of Marsember have thus far failed.
Source: Monster Manual III, page 125.