Stage 3: Final Transformation

• Damage: Five points of Constitution and five points of Dexterity are lost. Their maximum hit point level goes down by the five times the maximum of their hit dies for their class. They also take three levels of exhaustion that cannot be corrected through a long rest.
• Indications: In the final stage, the victim's humanity is almost entirely lost. Their behavior becomes increasingly erratic and violent, with a strong aversion to consecrated or holy sites. The necrotic spots spread, covering the body in mottled, decaying flesh. The victim's eyes glow with a faint, eerie light, and they exhibit a pronounced sensitivity to holy symbols and objects. At the end of this stage, if not cured, the victim transforms into a ghoul.
• DC to Notice: A DC10 Medicine check is required to understand the full extent of the transformation process. At this point, the physical and behavioral changes are overt, but recognizing the imminent change into a ghoul demands a deeper knowledge of undead physiology and curses.
• DC to Resist Transformation: The victim must make a DC18 Constitution saving throw at the end of each day to resist transforming into a ghoul. Failure on this saving throw indicates the victim's transformation into a ghoul is complete.
• DC to Overcome Disease: At this critical point, overcoming the disease through natural resistance alone is nearly impossible, requiring a DC20 Constitution saving throw. This high DC reflects the severity and finality of the infection's progression. It is strongly recommended to seek powerful magical healing or intervention at this stage.