Middenworm

Creepers of sewers and crawlers within urban dump sites, middenworms are dangerous scavengers. Eager to abandon their bottom-feeding ways, they're known to attack living foes, for fresh blood is their favorite repast. A middenworm is unpleasant to look at, listen to, or smell: a greasy maggot-like worm with hooked jaws at one end that peel back the folds of its body when it bites, and a nest of long, red, blood-drinking tendrils at the other.

Giant Middenworms

Normally, a middenworm doesn’t grow much larger than a dog, as this smaller size affords them more mobility in the sewers they frequent. Yet rarely, when middenworms have more room to grow in an area that’s particularly infused with toxic magic or fiendish influences, these creatures can grow to enormous size.