You summon blood worms on a creature's body with a vascular system. The creature makes a Dexterity save as the worms try to burrow into it. On a failure, the creature takes 10d10 necrotic damage as the worms burrow into its bloodstream and an extra 5d10 damage at the start of each of your turns. On a success, it takes half the damage.
The blood worms greatly affect a creature that fails its save as they spread and multiply throughout its bloodstream and brain. While the blood worms remain in the creature's body, the creature moves at half speed and has disadvantage on attack rolls, ability checks, and saves. Also, the creature can't cast a concentration spell while infected with blood worms. If the creature's concentrating on a spell when first infected, it loses concentration. An infected creature can make extra saves at the end of each turn, ending the effect on a success.
* - (an earthworm that's consumed by the spell)
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