Bacterionomicon Digital PDF

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ng
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Credits
Concept
Cover art and Book Layout
Art coordinator
Kickstarter reward tier art coordination
Arun Mathews M.D.
Editing
Arun Mathews
Raul Gonzalez
Brandon Patton
Xiaolong Dai
Eric Chen
Brandon Patton
Gwen Hoffnagle
Hunter Slaton
Illustrations
Art Corgi
Mainon Schwartz
Atanas Stoykov
Zeeba Mathews
Changyu chen
Gong Kun
Consultant
David Malki
Grant Alward
Jimmy Yeung
Volunteer copyediting
Juan Diego Dianderas
Eric Chen
Mainon Schwartz
Lance Red
Liu Qiuhong
Special Thanks
MakeThatThing
Mei Hanlong
Quintek Group
Raul Gonzalez
Stephen Shek of QP Group
Storn Cook
Xia Xue
Zhu Wei
Lore Development
Arun Mathews
Brandon Patton
Eric Beal
Jef Akst
Zeeba Mathews
Writing
Brandon Patton
Jef Akst
ISBN: 978-1-56581-231-4
All characters, character names, and the distinctive likenesses thereof
are property of Nerdcore Medical. This material is protected under
the copyright laws of the United States of America. Any reproduction or unauthorized use of
the material or artwork contained herein is prohibited without the express
written permission of Nercore Medical. Any similarity to actual people, organizations, places,
or events included herein is purely coincidental.
Printed in China.
2014 Nerdcore Medical.
www.nerdcoremedical.com
The enemy of art is the absence of limitations.

-- Orson Welles
he Bacterionomicon was originally written to be a simple

compendium of creatures and heroes from the game that
we developed in 2009, the Healing Blade. it grew into so much

more. Initially envisioned as a simple companion book to further
enrich gameplay, the book took on a design and purpose all its
own. Indeed, while creating the book, we realized that we were
stepping beyond the bounds of gameplay, into the rarefied realm of
world-building. But before we can talk of this, it is perhaps fitting
to talk of the idea that brought all of this to pass - the genrebending experiment known as the Healing Blade.
Origin Story: Cognitive Rehearsal
One morning after an evening of involved video-gaming some years back, I

was completing rounds in the medical intensive care unit with a nurse and
a student. The question came up: How does one choose the appropriate
antibiotic for an infection when the infection has not been proven by way of
cultures or Gram stain? Gram staining is where certain types of bacteria take
up a chemical stain (Gram positive) while others do not (Gram negative). The
cultures and Gram stain become confirmatory tests which then leave us with
the decision which antibiotic does one choose?
As I pondered this question, I started noticing parallels between the battle to
contain infection and my fictional video game battle from the night before.
Engaging with the dark forces of infection reminded me of switching weapons
in a video game to defeat a specific type of foe. We are able to make very
reasonable assessments in regard to which antibiotics (weapons) to use against
the forces we suspect are attacking an individuals body. If there ever was an
aha! moment regarding the Healing Blade concept, that was it.
After two days of playing around with the idea, it occurred to me that using a
battle metaphor to simulate engagements between antibiotics and microbes
would allow people to rehearse real world decision-making prior to stepping
into a hospital and treating patients. While there are general rules which can be
applied to making sound initial antibiotic choices, there are also several subtle
nuances when it comes to antibiotic selection. One example is the differences
between healthcare-related pneumonia and community-acquired pneumonia.
Community-acquired pneumonia tends to imply certain standard bacteria,
while healthcare-related pneumonia can indicate more resistant bacteria such
as MRSA, Pseudomonas aeruginosa, and atypical organisms. In addition,
concerns about antibiotic resistance come into play.
This is the kind of information we hoped our game would allow players to learn
and rehearse prior to entering a hospital. It was one of the founding precepts
of Healing Blade. As we developed a very basic concept document, we also
settled on the concepts we wanted students to learn while playing the game:
1)
A respect and appreciation for antibiotics in general. These agents have
truly revolutionized the field of medicine a notion that is sometimes taken for
granted. While impressive, they can also have deleterious side effects.
2)
An introduction to the concept of antibiotics stewardship, which
is methodology for responsibly using antibiotics in the hospital. When
unnecessarily potent antibiotics are used to treat a mild infection, the stage is
set for antibiotic resistance. We wanted to teach this through our gameplay.
When, in the game, the antibiotic card player inappropriately uses very
powerful antibiotics, it essentially gives away that individuals hand, allowing
the bacteria card player to make strategic decisions and/or implement a
resistance magic card.
3)
Features of the bacteria and the diseases themselves. For instance,
Clostridium difficile is represented as a hulking monstrosity releasing spores
from its back. The imagery of the spores alludes to the bacterias primary
mode of transmission, and the size suggests its virulence and potential for
harm.We also tried to create parallels between fantasy lore and microbiology
lore. An example of this is our handling of the bacterium Staphylococcus
aureus. In fantasy literature, dragon mythology is as intricate as it is complex
and expansive. We created a similar mythos with Staphylococcus aureus.
Basic Staphylococcus aureus as depicted in our game is a very simple, small
dragon whose skin is a yellowish hue. This is compatible with the commensal
bacterium that occurs in our skin and is largely harmless. When resistance
plasmids drive the virulence of Staphylococcus aureus, infected pathologies
can occur. This brought to mind more powerful dragons, from the frightening
methicillin-resistant Staphylococcus aureus to the terrifying multi-headed
Golden Dragon that is vancomycin-resistant Staphylococcus aureus.
4)
We hoped that by playing multiple rounds of our game, students
would begin to recognize patterns of attack that were successful, in addition
to appreciating the nuances of using certain antibiotics against certain types
of bacteria. We hoped this rehearsal would better inform some of the clinical
decisions that the students would make later in their medical careers.
With these four guiding principles in place, we set to the task of hiring a team
of artists and building the world that would be the backdrop for our game
the world of Soma.
viii
ix
Realism vs. The Abstract
In the months after the release of the original version of the game, we were
often asked, Why are the bacterial creatures fantastical? Such questions
inevitably came from members of the scientific community who had grown
to know and love these organisms as the various different iterations of singlecelled organisms that they are. To us, slightly different spherical organisms
with slightly different distinguishing features, including those resulting from
Gram staining, while interesting to a certain subset of the population, did not
capture the interest of our key demographic. Incidentally, creating a blank
slate from which we could build any creature and implement various features
of bacterial morphology, disease pathophysiology, and clinical features
proved freeing and, at the same time, somewhat daunting.
Regardless, this was the direction in which we opted to proceed, and
ultimately we were happy with the results. This approach also made the
artists task of conveying our ideas somewhat simple, as they werent
challenged with trying to draw multiple iterations of single-celled organisms.
A Methodology for Art Creation
Fundamentals in place, and an overarching directive to focus on things that

were cool over things that were realistic, heralded the next step of our
journey which involved working with an art director and a small team of
artists based in China.
Serendipity came into play here, as the perfect fit for our art director, Xiaolong
Dai, happened to be a roommate of one of the original developers, Dr.
Francis Kong. Mr. Dai was completing a degree in design in San Francisco,
and had multiple contacts with artists in China. He proved to be very detailoriented, and he was extremely diligent in obtaining detailed descriptions of
both the antibiotic agents (referred to as Apothecary Healers) and the various
species of bacteria (referred to as Lords of Pestilence).
We then developed a short list of the various bacteria and antibiotics that
would be included in the game based on a number of sources. We referenced
therapeutic and microbiology tomes that we had come across in our medical
education. We also built our list based on our clinical experience during rounds
with medical and nursing students and internal medicine residents. My wife and I
had both worked as chief residents in our internal medicine residency programs,
and had some experience with the process of creating needs assessments in
clinical education.
Inclusion criteria for the antibiotics included agents that we encountered and used
on a day-to-day basis. There were antibiotics that had certain special side effects
and/or considerations for use that we wanted to include. We also wanted to create
an even balance of broad-spectrum versus narrow-spectrum antibiotics for certain
strategic elements of play that echoed the administration of said antibiotics in the
real world.
For the bacteria, we made sure to include sufficient Gram-positive, Gramnegative, anaerobic, aerobic, and multi-drug-resistant bacteria to effectively
mirror the more common infections that would be found in both university and
community-based acute medical settings. We added a number of rarer infections
that are included in any standard microbiology or therapeutics text to reflect an
adequate breadth of scope for board review purposes.
When the list was close to being finalized, we began the arduous yet exhilarating
task of breaking down each bacterium into a composite that included cues to
its virulence, suggestions about what the fantasy equivalent of it might be, its
weaknesses, and its strengths. The following is an example of the development
process for the antibiotic Ampicillin:
Basic description:
A versatile front-line warrior whose name comes from the Latin root
meaning artists brush. Despite her delicate beauty, she is one of
the few fighters who can take down the malevolent VRE.
xi
We would then take the limited description and use it to help build the
imagery for the artists to work on. The artists would create a rendering sketch
and send it back to us for review and touch-ups. This would allow us enough
time to continue to build the basic concept of the character. Once we were
happy with the sketch, we would release the art for final development. The
following is the final image that we developed for ampicillin.
The Bacterionomicon: An Exercise in World-Building
After the cards were developed, it occurred to us that we could further extend
our metaphors for microbiology and therapeutics into a larger ecosystem that
also took into account the surrounding environment. Since the human body
was the backdrop in which all of these battles would occur, why not create
additional allusions to physiological processes within our world? Inspired by
the various fantasy worlds that we had grown up with, including Middle Earth
and Narnia, we set about to increase the scope of our game substantially.
Hence the concept and backdrop for our game was born Soma with its
primary themes being interconnectedness and balance, or homeostasis.
Given this new direction, we hired a science writer to help us flesh out each
character. Below is the extended backstory of the character Ampicillin:
The penicillin tribes have a long and proud ancestry that dates
back to the dawn of Soma. It was this family that struck an
accord with the creatures of Pestilence, allowing for balance
between the realms of creature and healer. But with the rise
of the dark entity named Vallejio, this delicate arrangement
was broken. Ampicillin played an important role in these early
engagements and fights in conjunction with other healers that
carry the beta-lactam banner. Her main form of attack involves
her broadsword that, with the aid of its special amino ring,
slices through the armor of certain types of pestilence.
This is an example of
a finalized card.
xii
There was a time that Ampicillin, with her predictable attack

patterns, was relegated to front-line or initial scouting missions.
However, during the famed Incident of KazJiek where a small
band of reconnaissance healers were ambushed by Vallejio and
the horrific multi-headed Vancomycin-resistant Enterococcus,
it become apparent that Ampicillin had a clear role to play in
the War for Soma. Of the thirteen or so healers in her party, she
was the only Apothecary healer left standing that day, able to
survive VRSAs attacks and even deal damage, before escaping
to inform the leadership of this dread new foe.
xiii
In the following description of the antibiotic Azithromycin, note how the

various environments of Soma are starting to be developed as metaphors for
human body systems and physiologic processes:
e sincerely hope that you enjoy the exercise in

conceptual blending and learning through
metaphor that is the Bacterionomicon. Indeed, what

a magical time we live in, where we can envision such
a concept, coordinate with artists and designers to
breathe life into it, and then ask the good people of
the interwebs to place their faith in it and pledge
their hard-earned coin to bring it to reality. We can
safely say that this idea was at the same time nurtured,
marketed and enhanced by the incredible community
that was Kickstarter, and to these lovers of art and
science, we are extremely grateful. Were constantly
looking to improve upon the work and would greatly
Azithromycin, son of the great Erythromycin, is one of the most commonly

called-upon Apothecaries. Like his mother, he inhibits the ability of the
Pestilence armies to generate the basic structures of life, killing them from the
inside out. Because of their similar attack styles, the two are effective against
a similar range of Lords, though Azithromycin has a slightly better track
record against those of the Gram Negative Legion, particularly Haemophilus
influenzae. Furthermore, unlike his mother, Azithromycin is not susceptible
to the acidic waters just above the Southern Dam, and can thus enter the
aqueduct unprotected, simplifying his journey to the site of battle.
Azithromycin is capable of launching an effective counterattack against a
wide range of Lord species, including those that invade the aqueduct entrance
at the back of Buccal Bay, the Occulos, and the Respiro Forest. He usually
enters through Buccal Bay and is often transported to the site of infection by
the Nodal Sentry. He is even sometimes sent in preemptively, when the Nodal
Sentry is compromised in some way and the risk of a Pestilence attack is high.
Like most Apothecaries, however, Azithromycins protection comes at a cost.
His presence can disrupt the flow of the aqueduct, causing it to discharge too
quickly or even reverse directions. Furthermore, he has been known to put the
Twin Heart Cities at risk, particularly if they are already impaired.
xiv
appreciate any feedback, thoughts and suggestions. In

the fantastical text descriptions and artwork for each
character you will notice many little references to
real world facts. We hope that you receive just as much
of a thrill discovering and deciphering our various
Easter eggs, as we had laying them, the egg laying purple
bunnies of awesome that we are!!
Evermore,
AM
Contents
Contents
Apothecaries
Lords of Pestilence
6
7
8
9
10
11
12
13
14-15
16-17
18-19
20-21
22-23
24-25
26-27
28
29
30
31
32
33
34
35
Acinetobacter baumannii
Bacillus anthracis
Bacillus cereus
Bacteroides fragilis
Bartonella henselae
Bordetella pertussis
Borrelia burgdorferi
Campylobacter jejuni
Clostridium difficile
Clostridium perfringens
Clostridium tetani
Corynebacterium diphtheriae
Coxiella burnetii
CRE
Enterococcus faecalis
Escherichia coli
Francisella tularensis
Fusobacterium necrophorum
Haemophilus influenzae
Helicobacter pylori
Klebsiella pneumoniae
Legionella pneumophila
Listeria monocytogenes
MRSA
mutans streptococci
Mycobacterium leprae
Mycoplasma pneumoniae
Neisseria gonorrhoeae
Neisseria meningitidis
Nocardia asteroides
Pasteurella multocida
Proteus mirabilis
Pseudomonas aeruginosa
Rickettsia rickettsii
Salmonella typhi
Shigella
Staphylococcus aureus
Staphylococcus epidermidis
Staphylococcus saprophyticus
Streptococcus pneumoniae
Streptococcus pyogenes
Treponema pallidum
Vibrio cholerae
VRE
VRSA
Yersinia pestis
36-37
38-39
40-41
42
43
44
45
46
47
48-49
50-51
52
53
54-55
56
57
58
59
60
61
62-63
64-65
66-67
74-75
76-77
78
79
80-81
82-83
84-85
86-87
88
89
90
91-92
93
94-95
96-97
98-99
100
Amoxicillin/Clavulanate
Ampicillin
Ampicillin/Sulbactam
Azithromycin
Aztreonam
Cefazolin
Cefepime
Ceftazidime
Ceftriaxone
Chloramphenicol
Ciprofloxacin
Clindamycin
Doxycycline
Ertapenem
Erythromycin
Gentamicin
Imipenem/Cilastatin
Levofloxacin
Linezolid
Metronidazole
Oxacillin
Penicillin
Piperacillin/Tazobactam
Streptomycin
Tetracycline
Ticarcillin/Clavulanate
Tigecycline
Tobramycin
Trimethoprim/Sulfa
Vancomycin
101
102-103
104-105
106-107
108-109
110-111
112-113
114-115
116
117
118-119
120-121
122-123
Healing Blade Interactions

Real World Interactions
KickStarter Backers
124-125
126-127
128-133
6Landmarks6
Auditoria - Ears
Occulos - Eyes
Sententia - Brain
Respiro Forest - Lungs
Caverns of Bladdara - Bladder
Waste Processing City - Liver
Marshes of alimentum - Intestines
Hemofactory Outpost - Spleen
Nodal Sentry - Lymph Node
Twin Heart City - Heart
Southern dam - Stomach
Lymph Lakes - Lymph Nodes
Boundary wall - Skin
Northern forest - Nasopharynx
Pharyngeal Path - Throat
Bacteria Type
Cocci
Lancet
Grape Cluster
Rod
Bulls Eye
Diplococci
Fusiform
Filament
Coccobacillary
Chained Sphere
Spiral
gram (-)
gram (+)
Attack
Defense
A. baumannii
Aliases: Motionless One, Iraqibacter,
M-DRAB
Sicken forest, contaminate waterway,

flay skin, copy weapon
Nemesis: Imipenem
Gelatinous pelt, adaptive defenses,

copy armor, remain motionless, endure
harsh conditions
Affinities: Infirmaries, Battlefields
Bacillus anthracis
Alias: Anthrax
Nemesis: Fluoroquinolones
Affinity: Cattle
The very first Lord of Pestilence identified as a source
of mysterious suffering. The name anthracis
comes from the Greek word for coal, due to the
blackened flesh of its victims.
Scholars who study these monsters have

noticed that, under the microscope,
they have no flagellum.
A. baumannii is very slow, oozing through the landscape

like a gruesome sludge, waiting patiently before
pouncing on its victims. It has been trolling the hills
of Soma for a century, and is one of the most virulent
threats to the warring world. It can afford to be slow
because its flexible form makes it extremely difficult
to defeatand it adapts well to changes in environment,
allowing it to withstand Somas seasonal fluctuations in rain
and humidity. As battles wage on, A. baumannii becomes ever
more powerful, feasting on scarred land and fallen soldiers, and
garnering the weaponry of fallen comrades to power its wrath
and evade enemies. It has acquired nearly 40 different tools of
warfare from other Lords such as Pseudomonas, Salmonella,
and Escherichia, and is presumably always collecting more.
It is fueled by war, and if it is not eliminated quickly, it
will become too widespread to kill.
Burn, bite, venom, suffocate,

toxic spores
Protein carapace,
remain dormant
This horrific basilisk is a dreaded foe. With
the advantages of its amphibious lifestyle and
a shielding protein carapace, B. anthracis is a
formidable threat to Soma. At one time, it was
totally vulnerable to the valiant Beta-Lactam
Apothecaries, although nowadays there are
increasing reports of resistanceand, as is
typical of many Lords of the Stained Legion, by
the time help has arrived, it is often too late.
Infestation results in a blackening of the earth
and the release of deadly spores, which can
remain dormant, like time bombs, for an age.
A. baumannii is notorious for adapting to Soman

defenses and learning to resist Apothecary warriors
that once could defeat it. These days there are
only a few Apothecary warriors that can stand
against A. baumannii; most cannot penetrate
its gelatinous pelt. Fortunately, some
younger healers have developed creative
approaches to sidestep the monsters
defenses and bring it down. With any
luck, their collective efforts will
put an end to this fearsome
predators devastating attacks.
B. anthracis is armed with a lethal trio of

attacks: fire, vicious fangs, and a venomous
bite, all of which enhance one another when
used in concert. Without its fire, B. anthracis
cannot get close enough to its prey to deliver its
lethal strike.
But once a field is reduced to ashes, it can attack the exposed and unprotected area, feasting on its
victims until it has been sated. With a single bite, B. anthracis can inflict tremendous swelling, which
suffocates the surrounding flora and faunaand, if it is able to inject its poisonous sap, widespread
death can occur within days.
While Somas chemical-laden underground springs provide the soil, shrubbery, and subterranean life
with a protective bath against venom, B. anthraciss presence becomes harder to endure the longer the
battle rages. Furthermore, Somas rainy season can dilute the waters potency, negating its ability to
defend against this awesome beast.
Lords of Pestilence | Unstained Legion Cocci | Coccobacillary | Rod
Lords of Pestilence | Stained Legion Rod
Bacillus cereus
Aliases: Cereus, Rice Demon
Nemesis: Vancomycin
Affinities: Warm swamps, rice fields
Usually not lethal. Many are peaceful.
Spread a sickness called Fried Rice

Syndrome, manipulate fluids, toxic
spores, claw, bite
B. cereus are hardy reproducers, laying spores that can

survive temperatures of up to 100 degrees Celsiusthe
point at which water boilsin the hot swamps that
surround the banks of the Marshes of Alimentum through
Somas Southern Dam region. Once the marshy waters
temperature drops below 50 degrees, the spores begin to
germinate, emerging as fully grown, bison-sized creatures,
sporting waxy scales, talons and fangs that compete both
in size and degree of destruction inflicted, and a head
larger than a mammoths.
These creatures claw their way down the banks of the

Marshes of Alimentum, sending searing pain into the
Waxy skin and scales, heat-resistant
habitat through the very earth itself. As they reach the
Marshes of Alimentum, just south of the Southern Dam
and thus safe from the branch of the Nodal Sentry that patrols this region, they release poisons that disrupt
the harmonious flow through the marshes, sending unusual volumes of water both up and down their
channels. These toxins, resembling large empty barrels, float to the edge of the marshes and burrow into the
banks, creating pathways directly into the surrounding soil. Some B. cereus produce a particularly powerful
toxin that affects communication to and from Sententia and is capable of surviving extreme heat and both
high and low levels of acidity, allowing it to survive the changing conditions of the marshes. These brutal
creatures also can make their way to Somas Boundary Wall, where they can survive for long periods of time,
causing sores and other irritation.
Bacteroides fragilis
These fetid bottom-feeders are important to Somas
natural ecosystem, although they can become
malevolent. It is suspected that they act as sleeper
agents, aiding other emissaries of Pestilence.
Widespread in Soma, where they are among the
most common residents below the Southern Dam
and near Fecal Inlet, they can live peacefully along
the Marshes of Alimentum, where they feed on the
nutrients and other resources that flow from Buccal
Bay. But they abandon their peaceful lifestyle when
battle damage to the banks of the marshes allows
them to travel to nearby towns and cities, which
they normally cannot visit. Once in these unfamiliar
places, B. fragilis unleash a suite of deadly poisons.
Nemesis: Metronidazole
Affinity: Cats
Most are peaceful. Opportunistic
attackers in times of strife.
Bite, flay skin, poison, plant bombs,

paralyze, copy weapon, Lacta Mace
Adaptive defenses, copy armor, does
not require oxygen
Among their weapons is a toxic bomban enclosed capsule loaded with an acidic venom that paralyzes
Somas Nodal Sentry, preventing it from reaching the site of battle. If the appropriate Apothecaries are not
deployed in time, such attacks can be fatal.
Furthermore, B. fragilis do not
only fight alongside other Lords
of Pestilence, they also share
their secrets. Thanks to close
living quarters with other
marsh-dwelling Lords such as
E. coli, B. fragilis can take up
weapons and armor that prove
most successful against Somas
inhabitants and defenders.
The presence of B. cereus, a relatively

uncommon tormenter of Soma, is
difficult to distinguish from
other marsh-dwelling Lords
of Pestilence, such as
and Staphylococcus
aureus, but can be just as
vicious. Yet many B. cereus
also have a more benign
side, and inhabit the marshes
as peaceful contributors to
the community, helping to
limit invasions by more
consistently violent Lords,
such as Salmonella and
Campylobacter.
Alias: Break-Apart Scavenger
Lords of Pestilence | Unstained Legion Rod
Bartonella henselae
Aliases: Fever-Claw Puma, Paranoia Cat,
formerly known as Rochalimaea henselae
Nemeses: Doxycycline, Macrolide family
Affinity: Cats
Usually not lethal.
Bite, venom, manipulate fluids,

infecting claws can cause fever,
temporary blindness, tumors
Heat-resistant, thick hide
This massive feline creature, which resembles an

otherworldly lion, is fond of clawing attacks, going directly
for the victims eyes and visceraand even its bite can
induce feverish delirium. The creatures, which often
attack when Soma is already weakened from battling
another Agent of Pestilence, scratch their way through
the Boundary Wall and then roam across the land,
launching themselves at their prey, sinking in their claws
and clamping down their teeth. Their grasp contorts their
victims insides, while the giant cats inject venomous
proteins to finish the kill. B. henselae regularly exchange
the recipes for their toxic injections, strengthening the
killing power of the whole group. Furthermore, they
are robust against Somas varying weather conditions,
equipped as they are with a fortified fur coat that protects
them from changing temperature and acidity.
Once they enter the land, getting rid of them is no easy task. If the proper Apothecaries are not unleashed
quickly enough, B. henselae can spread throughout the land, from the Nodal Sentry headquarters in the Skeletal
Mountains and Lymph Lake system to the Marshes of Alimentum and filtration centers, eventually finding
Sententia, where they disrupt Somas ability to coordinate its operations. Even more threatening is B. henselaes
ability to redirect Somas waterways in service of
their own survival.
Bordetella pertussis
These elemental creatures float on
the breeze until they can anchor
themselves to the canopy of Respiro
Forest, where they unleash a
sophisticated chemical assault. They
attach poisonous globules to the
tree branches, which set a cascade
of events into motion: the poison
paralyzes the branches, which
become dusty and polluted, choking
the entire forest. The sudden lack
of air awakens the forests roots to
trigger powerful earthquakes that
shake the trees free of their debris
which, in turn, launches B. pertussis
airborne yet again, to invade new
regions of the woodland. As the
earthquakes subside, travelers
can hear the eerie sound of the
creatures whooping cries echoing
in the wind.
Aliases: Pertussis, Haemophilus pertussis

Nemeses: Macrolide family
Affinity: Children
Distinctive whooping sound.
Sicken forest, poison, suffocate, create

earthquakes, paralyze, cause dizziness,
confuse
Anchoring tethers
B. pertussis has additional chemical

weapons as well, poisons that
confuse Somas Nodal Sentry,
disturbing the defenders sense of
balance, garbling their signals, and
disabling their ability to absorb the
enemys blows. Worst of all, this
invader tends to target children
and, with such sophisticated
chemical attacks, they are extremely
difficult to repel once they have
invaded. Somas strategy to deal
with them has evolved to one of
constant vigilance and preemptive
security, which, when followed
diligently, can successfully prevent
the attacks from ever beginning.
1012
Lords of Pestilence | Unstained Legion Coccobacillary
1311
Campylobacter jejuni
Borrelia burgdorferi
Alias: Lyme Monster
B. burgdorferi have
two forms. They begin
as giant lime-green
arachnids with powerful
harpoon-like mouths that can
pierce holes in Somas Boundary
Wall. They then cast aside their giant exoskeletons to
sneak into Soma through these holes. Once inside,
free of their arachnid shells, the creatures resemble
very long and narrow squid, with a mass of tentacles
trailing behind them. These powerful appendages
propel the soft-bodied Lords through the stream and
river system, including the thickest swamps, reaching
into the far corners of Soma.
Nemesis: Doxycycline
Affinities: Giant ticks, rodents
Has two forms, a lime-green arachnid and a long,
narrow squid. Leaves red bulls-eye-shaped mark after
penetrating Boundary Wall.
This cunning witchs name means twisted, in

acknowledgment of her serpentine formand her
twisted reputation. She resides in the feces of wild
fauna and in putrid, oxygen-deprived swamps,
preparing poisonous treats and hatching schemes
to torture the innocent. She invades Soma through
Buccal Bay, contaminating that water as she goes. Her
noxious presence actually prevents living things from
growing. When she encounters Soman inhabitants,
she charms them and offers seemingly delicious
treats, which release debilitating poisons once eaten.
She also poisons carelessly guarded food, especially
the flesh of poultry, to spread sickness without being
discovered. Her poisons, although usually not lethal,
cause pain and misery for seven days or more.
She can manipulate the waters of the Marshes
of Alimentum, causing violent upheavals and
damage to the Southern Dam and the banks
of the marshes, as defensive sentry rush to the
scene and overreact. Fortunately, C. jejunis
visits are usually short-lived, and she can be
easily defeated in combat by a number of
Apothecary warriors.
Aliases: Jejuni the Twisted, Guillain-Barr

Nemeses: Macrolide family
Affinities: Chickens, cattle, kangaroos
Usually not lethal.
Charming gaze, poison water/food,

blow up dam, manipulate fluids,
stealth, paralyze hands/feet
Weaponized back-plates, bite, sabotage,

paralyze, confuse, burn, exhaust, heat
wave, cause minor earthquakes, swell
Avoid detection
Unlike the more aggressive Lords, once inside Soma they usually keep a low profile, staying hidden,
changing their appearance to disguise themselves, and biding their time. As they wait, they gain
power. Their initial attacks of sabotage are subtly orchestrated to look like everyday accidents. Soman
inhabitants begin to suffer minor discomfortsbut not enough to raise alarm. The land begins to swell.
Gradually they become more bold, and the longer they survive in Soma the harder they are to eradicate.
On their backs, they grow a unique set of weaponized plates, which they use to terrorize all who cross
their paths. These plates can be interchanged and rearranged to torture Somans in different regions,
in different ways. From the Skeletal Mountains to Sententia and even Twin Heart City, Somans suffer
terribly once B. burgdorferi make their presence known.
Because of this behavior, prevention of invasion is the most effective defense. Sententia and the Occulos
regularly coordinate perimeter searches. When found along the Boundary Wall, or caught in the act
of tunneling through, B. burgdorferi are quite vulnerable and easy to destroy. Even when the scouts
arrive late to the scene, the discarded arachnid carapace and a distinctive red bulls-eye on the wall
betrays the presence of B. burgdorferi, and Doxycycline can usually hunt them down.
12
Lords of Pestilence | Unstained Legion Spiral | Bulls Eye
Lords of Pestilence | Unstained Legion Spiral
13
Clostridium difficile
Aliases: Seediff, Toxic Megacolon

Affinities: Infirmaries, battlefields
Toxic megacolon, toxic spores,
manipulate fluid
Indestructibility, survive without oxygen
C. difficile are fierce monsters whose hordes are
growing both in number and in hostility. Once
mostly restricted to the lands infirmaries, preying
on the weak, C. difficile have in recent years begun
to attack a wider range of Somas habitats and
citizens. They tend to appear just as other battles
have ended, finding opportunity in the wake of
destruction. In areas of heavy combat, particularly
those involving reckless, overzealous Apothecaries
that leave Soma stripped bare even of its beneficial
residents, C. difficile seize the opportunity and
flourish, filling that vacancy, delighting in the lack
of competition and seeking total domination.
These creatures take their namesake to heart, as
they are very difficult to kill. They grow nearly
indestructible toxic spores from their backs as
one of their means of reproduction. As they
overpopulate and disperse more and more toxic
spores, they strain the structural integrity of the
banks of the marshes, especially near Fecal Inlet,
threatening to burst through the lining and send
toxic sludge into the Soman fields and forests,
killing all life. Furthermore, C. difficile often strike
the same area more than once, and seem to have
favorite regions they return to repeatedly. And,
due to their spores, which can remain viable for
long periods of dormancy, they also are very adept
at spreading. Newer breeds of the creature are
producing even more spores, covered with even
more sticky hairs, which they use to hitch rides to
vulnerable regions of Soma.
15
Alias: Spore Dragon, Gangrene
Nemesis: Penicillin
Affinity: Battlefields
Normally peaceful inhabitant of Soma,
but can turn violent.
Toxic gas, manipulate

fluids
Armored wings, survive
without oxygen, resist heat
A weaker cousin of the frightening C. difficile, Clostridium perfringens are common
residents of the marshes, where they often keep to themselves. But they arent always so
peaceful. They can display a nastier side when provoked, disrupting the ecosystem of
the marshes, causing unrest among their inhabitants, and even escalating their attacks
to kill. The smell of decaying flesh arrives even before death itself, as C. perfringens
release a gaseous toxin that slowly rots the earth, like a sea star turning its stomach
inside out to digest its prey before actually consuming it. They are ever-present
during times of war, feasting on the open wounds along the Boundary Wall left by
brutal combat. If those who deploy the Apothecaries even suspect the presence
of C. perfringens, they rush into battle; the risk of delay is too great.
C. perfringens are clever beasts, more than compensating for their sedentary
state with a coiled tail anchoring them in place. They have broad, armored
wings that are often enclosed around themselves in a defensive stance.
They thrive in close, claustrophobic environments, which they often
create themselves by releasing gases such as carbon dioxide. Noxious C.
perfringens most often enter Soma through Buccal Bay, digging the hooked
talons at the tips of each of their wings into the backs of unsuspecting fish
and other animals swimming from the dam down into the marshes. Their
spores can survive periods of extreme heat in the waterway, germinating
to cause upheaval along the waterway banks and the Southern Dam.
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Clostridium tetani
Aliases: Rust Golem, Tetanus, Lockjaw,
Puppet Master
Nemeses: Vaccine, Metronidazole
Affinities: Dirt, manure, nails, salvage
yards, dirty needles
Puncture, claw, tear, scratch, cause
earthquakes, paralyze, cleave, trap,
puppet mastery.
Indestructibility, dig deep
underground.
C. tetani are animated golems made of rust that can puncture through the Boundary Wall with their
massive, poison-tipped claws. They easily continue on through Soma, unstoppable, even clawing their
way deep inside the Skeletal Mountains or through the streets of Sententia. Their poison, one of the most
potent in existence, causes the very land to tremble and quake.
The tetani have a distinctive stiff smile that never changes expression, making them seem particularly
pleased by the suffering they cause. They are fond of dirt, manure, nails, salvage yards, and dirty
needles, but they avoid fresh air. Three notorious individuals named Risus Sardonicus, Trismus, and
Opisthotonus lead the C. tetani, usually appearing one after the other in multiple waves of attacks. Metal
weapons crumble in their presence, and the air becomes hard to breathe. They can paralyze victims that
come too near, or even worse, they can control them like puppets, forcing them into painful spasms,
and bending them backwards into unnatural positions.
They are powerful and extremely deadly. Only Metronidazole has had any success fighting them,
and only in small skirmishes. All of Soma would be constantly at threat from these Lords if not for the
discovery, many years ago, that they are appeased by worship. Now that lifelike but harmless statues of
these rust golems are posted like scarecrows throughout the land, and erected anew every ten years, the
tetani do not invade. Oddly it is this massive artistic effort, rather than the valor of Apothecary Healers,
that keep the tetani at bay.
Thanks to Kickstarter backer Dr. Jeevan Gowda, M.D., for choosing and funding this entry!
18
19
Corynebacterium Diphtheriae
Alias: Strangler Ghoul, Klebs-Lffler bacillus,
Children of the Coryne
Nemeses: Vaccine, Balto the sled-dog
Affinity: Children
Especially vulnerable to iron weapons.
Strangle, suffocate, burn, manipulate

temperature, grey slime
Leather hide
In ancient times, the leathery-skinned, tattooed, bull-necked ghouls known as C. diphtheriae once
roamed the land strangling children and leaving behind their greyish drool.
More recently, it was discovered that the ghouls themselves are victims. Mind-devouring
replicants called bacteriophages attach themselves to the heads of C. diphtheriae and use a
needle-like appendage to inject material into their brains. It is only then that C. diphtheriae
turn violent and begin their infanticidal rampage, driven mad by the needle in their brains, and
manipulated like puppets by these evil parasites. Once mounted by a phage, C. diphtheriae
usually will roam the Pharyngeal Path in search of child victims. They either strangle these poor
children, or cough up a viscous grey slime into the childrens mouths, suffocating them. They have
also been known to punch holes in the Boundary Wall to welcome other Strep and Staph Lords
into Soma, or even lay waste to the Heart Cities.
There are four different clans of C. diphtheriae: the mitis, intermedius, gravis, and belfanti,
although the belfanti are not driven to violent rage like the others. They are distinguished by
different tattoos, and different feeding habits.
They can be defeated by most Apothecary Healers, but their presence declined long before the
Healers arrived. According to a legend called the Great Race of Mercy, a sled-dog named Balto
arrived with a group of gnomes from the frigid north and frightened away the ghouls. Nowadays,
to celebrate the occasion, villagers erect leather effigies of C. diphtheriae every ten years, during
the harvest. These scarecrows are sometimes called Children of the Coryne. It is said that the
ritual maintains Baltos magical protection, and that C. diphtheriae are only ever seen in places
where this tradition has been lost.
20
Thanks to Kickstarter backer Rahul Yaratha for choosing and funding this entry!
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Coxiella burnetii
Alias: Querying Sphinx
Affinities: Ticks, cattle, goats, sheep
Q fever
Resist heat, resist light
C. burnetii is a sphinx that asks its victims a question, and kills
them if they answer incorrectly, by giving them Q fever, which
burns their minds, shakes their bodies, and eventually suffocates
them. They are evil creatures, who revel in torturing all manner
of Soman inhabitants, and are some of the most invasive of all
the Pestilence agents. If only a few manage to enter through the
Respiro Forest, they can multiply and spread throughout the land.
They are highly resistant to most natural defenses, including heat,
the suns rays, and standard cleansers that are used to purge the
land of lingering invaders after other battles have drawn to a close.
When C. burnetii enter Soma, they trigger pain and discomfort in
Sententia, irritation in the Respiro Forest, and other relatively mild
annoyances. If untreated, their armies grow and linger for months.
There are only a handful of Apothecaries that can defeat the Lords,
some only through a combined effort. Until recently, it had been
impossible to capture C. burnetii alive, so all that was known
about the horrid creatures was what the Apothecaries could report
from the field. Recently developed techniques for raising them
in captivity in a highly sterile environment will hopefully lead to
better knowledge of their weaknesses.
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CRE
Aliases: Carbapenem-resistant
Enterobacteriaceae, nightmare bacteria,
superbug, CRKp, KPC, NDM
Nemeses: None
Affinities: Infirmaries
Suffocate, groin strike, burn,
contaminate, manipulate fluids,
psionics, Metallo-Enhanced Mace,
Carbapenem Mace
Adaptive defenses, telepathy,
teleport enemy, force shield,
immune to stainless steel
CRE is the name of an elite cabal of mutant Lords who usually recruit Klebsiella or E. coli to join their ranks.
Only recently discovered, theyve caused widespread concern because they are nigh invincible. When the
cleverest members of the Enterobacteriaceae family are recruited, they undergo a transformation, assuming
a new hideous form with tentacles and glowing eyes, and become part of a hive mind with an encyclopedic
knowledge of history and tactics. Their telepathic communication gives them perfect military intelligence and
the ability to adapt instantly in battle. Only Tigecycline has had any success against them, but Tigecyclines
powers are weakest in the waterways of the Twin Cities, which the CRE use to their advantage.
The CRE possess a psionic ability to teleport their opponents out of their way, which makes them impossible
to strike with melee weapons, and leaves their opponents disoriented and off-balance. They are also
protected by invisible force fields that protect them from ranged attacks and make them immune to stainless
steel. On offense, they wield Metallo-Enhanced weapons, upgrades to the feared Lacta Mace of their
brethren that can shatter magic rings and Apothecary weapons. Their only known weakness at this time is
copper, from which they recoil.
Some CRE attack the channel to the Southern exit, some attack the Southern Dam and set the walls below
the dam ablaze, some attack the Heart City waterways, and some attack Respiro Forest, leaving a distinctive
bloody jelly behind. But one pattern has emerged: they attack areas that have already seen battle. In fact,
they seem to only turn against Soma in response to the presence of Apothecary Healers, almost as if they
were personally offended. Because of this, Somans have become wary of summoning Apothecary Healers for
lesser conflicts, afraid that the CRE may follow in pursuit.
Being that the Apothecary Healers have little power against them, Somas best hope is to avoid angering
them, or to eradicate the places they like to inhabit. They lurk in dirty places, like Infirmary tool sheds or in
pools that medics use to clean themselves after battle. Vigilance, surveillance, and adherence to extreme
cleanliness are required to prevent the CRE from turning small battles into devastating ones.
24
Thanks to Kickstarter backer Jason Springs, for choosing and funding this entry!
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Enterococcus faecalis
Alias: Colonic Demon
Nemesis: Ampicillin
Affinities: Plants, mammals, birds, flies,
infirmaries, feces
Formerly believed to be a Streptococcus Lord.
Usually peaceful. Can teach adaptive defenses
to others of the Stained Legion.
Burning biofilm (spread by touch), contaminate,

shock
Adaptive defenses, survive without oxygen, endure
harsh conditions, impervious to weapons/chemicals
These fiery marsh demons are as mercurial as they are powerful, behaving
like disinterested immortals who occasionally meddle in human affairs,
perhaps out of sheer boredom. They are extremely hardy, able to live almost
anywhereeven without airand they eat nearly anything. E. faecalis seem
to prefer filthy and perverse amusements, reveling in dirt and feces (their
namesake), riding giant flies, and contaminating Apothecary weapons. They
have a deep knowledge of battle tactics and weaponry, and gladly share their
secrets with other Lords. This emboldens Somas enemies by providing them
with new means to elude Apothecary counterattacks.
Yet many E. faecalis remain peaceful residents of Soma, devoted to study and
causing no real harm other than the secrets they divulge. Some even have
been known to be upstanding members of the community. But when their
moods turn dark and brooding, their demonic viciousness reveals itself, and
their ferocity and adaptability make them terrifying foes. On the warpath,
they learn quickly how to evade Apothecary forces. They are also impervious
to many chemical weapons, and certain sword metals have no effect,
as if they were undead. Angry E. faecalis have been known to roam
through settlements near the Marshes of Alimentum and the
Caverns of Bladdara, setting them ablaze. They can even engulf
Heart City stone, by leaving behind a sticky, burning bio-film
wherever they touch.
Some terrified Soman villagers have taken to making
welcoming gestures and sending invitations to them in
the hopes of keeping them happyanything to avoid
triggering their wrath.
Lords of Pestilence | Stained Legion Cocci | Coccobacillary | Chained Sphere
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Escherichia coli
Aliases: Ekolai, Marsh Demon
Nemeses: Cephalosporins
Affinities: Feces, flies
Many are peaceful.
Burn, contaminate, groin strike,

copy weapon, manipulate fluids
Many E. coli are common inhabitants of the lower Marshes

of Alimentum where they can live harmoniously among
other Lords and citizens of Soma. They confine themselves
to the banks of the marshes, where they even contribute
to the overall health of Soma, producing key nutrients and
helping to prevent invasions by less peaceful wanderers.
Some worlds even invite these creatures into their
waterways to help maintain the equilibrium of the fragile
ecosystem.
But not all E. coli are alike. In fact, the group is so diverse
that only 20 percent of their heredity is shared across all
creatures. And a handful of E. coli, usually from outside
Adaptive defenses
of Soma, are not content to assimilate quietly in the lower
marshes. Those that have acquired weaponry from other
Lords take pleasure in wielding these tools of destruction against Somas inhabitants, especially travelers, and
spreading destruction along the channel to the Southern Exit, or even Respiro Forest. These nasty relatives usually
enter through Buccal Bay, by way of unclean water channels, and make their way down the marshes, causing
disturbances along the way. They can cause sudden
floods beyond the Southern Dam, causing a
rush of water through the marshes into
the Fecal Inlet, leaving the land and its
inhabitants unable to slake their thirst.
Such floods can threaten Somas survival
if the gentle flow through the marshes is not
quickly restored.
Francisella tularensis
Francisella tularensis are nasty Lords
Alias: Rabbit Demon
who have terrorized Soma for nearly a
century. Known as rabbit demons, they
Nemeses: Gentamicin, Streptomycin
can tear apart the Boundary Wall to
Affinities: Rabbits, squirrels, deer, chickens,
break through and wreak havoc on the
ticks, mosquitoes, flies
towns and cities within. The damage
they cause depends on which of the
four F. tularensis armies are attacking
Tularemia
and where they strike first. They most
commonly enter Soma through the
Escape artist (possibly potion-based),
Boundary Wall, but have also been
shredding of their corpses causes
known to descend on the Respiro Forest
dispersal and resurrection
or occasionally through Buccal Bay
and the Occulos. Unlike some Lords,
F. tularensis does not need Soma or
another land in order to survive, and can lurk in the waters surrounding the island country, striking without
warning. They are quick to move from one land to another, and are often stirred up when their burrows are
disturbed during land maintenance, making their threat widespread and unpredictable.
They are skilled at avoiding the defensive maneuvers of Somas Nodal Sentry, and can even use the
defenders own camp to multiply. Once sequestered by the Sentry, the rabbit demons break out of their
holding cells, thriving on the camps resources while creating countless new, young demons that burst from
the site and spread throughout the land. The details of F. tularensiss escape tricks are not well understood,
but some reports tell of powerful potions that are uncapped when they escape. Somas best bet is to deploy
one of the few Apothecaries that can defeat the evil Lords before their numbers become too great to
overcome. The rabbit demons cause a type of blood fever called Tularemia, which causes abrasions along
the Boundary Wall, wildfires, swelling of the Occulos, and potentially death of the land itself.
Once the violent E. coli are ejected from the

Fecal Inlet, the beasts can reinvade just east,
along the Boundary Wall, where outflow from
the Golden Streams occurs. These reinvasions
can then backtrack through the streams to the
Caverns of Bladdara, causing further unrest.
28
29
Fusobacterium necrophorum
Alias: Lemierres Monster
Affinity: Horses
Silence, choke, ice blockade

Touch causes thrush, survive
without oxygen
First discovered in the caves of Lemierre, this

monstrosity invades through Buccal Bay and its
primary tributary into Soma, spreading through
the rivers and streams, and poisoning and killing
off the land. Some suspect that Fusobacterium
necrophorum can live unnoticed among the
friendly Lords of Buccal Bay, but it is hard to say
with certainty, as they are rarely seen unless they
are wreaking havoc on Soma. Its more likely
that as other Pestilence agents enter the area, F.
necrophorum seize the opportunity to invade
undetected among the chaos. But whether they
are new trespassers or aggravated inhabitants is
immaterial; once they emerge from their cavern
homes, they are unwelcome guests of both the Bay
and the entrance to the Southern Dam, where they
slash large wounds along the waters edge.
Haemophilus influenzae
Haemophilus influenzae are some
of Somas most ancient demons,
first chronicled more than 100 years
ago. Despite a century of experience
fighting these foes and detailing their
heredity, their attacks are still poorly
understood. They continue to pose a
significant threat to Soma, wreaking
havoc on the lands rivers, Respiro
Forest, the Skeletal Mountains, and
even Sententia.
Aliases: Fluish Haemophile, Pfeiffer bacillus

Nemeses: Third-generation Cephalosporins,
Affinity: Battlefields
Burn, contaminate, suffocate, swell,
skeletal torture, choke, flay skin, cause
deafness, blind
Rune-magic, protective capsules
H. influenzae are a wide and varied

group, but the most troublesome organize themselves into six different Runic Battalions, each associated with a
different Rune of Power. Runic magic creates slimy, protective capsules that protect the battalions from Soman
counterattacks. Somans have worked around this powerful defense by developing preventive measures, although so
far they only deter one of the battalions. And even the H. influenzae that dont belong to battalions are capable of
causing harm just by summoning Somas Nodal Sentry, whose defensive tactics alone often lead to friendly fire.
Many H. influenzae agents are known to live quietly in Soma before springing their attacks. They lie in wait until
other battles occur, weakening Somas defenses, and then quickly dispatch themselves to the besieged towns and
cities. There, they can inflict widespread damage, choking Somas atmosphere by attacking the Respiro Forest,
causing pain and suffering in the Skeletal Mountains, or disabling the Occulos, thus inhibiting Somas ability to detect
incoming vessels. They also have a deep hatred of their fellow agents Streptococcus pneumoniae. The two have been
known to fight over territory, a behavior that Apothecary strategists can sometimes exploit to their advantage.
They silence and choke their victims, preventing

screams that might alert others to the danger.
They are also dangerous to riders on horseback. If
trampled by horses, their touch causes thrush that
leaves the horses lame, unable to carry on in battle.
They can create frozen icebergs in the rivers and
streams of Soma to use for travel, or to freeze and
clog the waterways that sustain Respiro Forest.
Such brutal invasions are relatively rare, however,
and the Apothecary Army isnt always quick to
react. F. necrophorum are often forgotten about;
their name is not always found in key historical
tomes that inform the Apothecary strategists in
designing their counterattacks. But if they do invade
and are not quickly controlled, they can creep
towards the Nodal Sentrys barracks and infiltrate
the transportation system used by the lands army,
or find their way to the natural waterways.
30
Lords of Pestilence | Unstained Legion Fusiform
31
Helicobacter pylori
Aliases: Helical Python, Campylobacter
pyloridis
Nemesis: Clarithromycin
Many are peaceful.
Tentacles, toxins, gash wall/lining,

transform Nodal Sentry into berserk
mutants, manipulate fluids, destroy appetite
Burrowing, anti-chemical scales
Helicobacter pylori primarily target the central regions of Somas Southern Dam, using their tentacle-like`
appendages to burrow into the dams protective lining, avoiding its defensive secretions. They furthermore take
advantage of the waste produced by Somas inhabitants to generate the energy they need to survive, and have
adapted to the relatively low oxygen levels of the semi-aquatic environment.
As the dam renews its magical lininga continual process that occurs to ensure the purity of Somas main water
lineH. pylori burrow farther into the wall. They protect themselves from purifying chemicals with specialized
scales that break down these chemicals and render them harmless to H. pylori, but damaging to Soma. Although
many strains of H. pylori live peacefully and keep to themselves, others cause severe damage to the dams walls.
Moreover, the influx of laborers required to repair the damage, and the slew of supplies they must bring to the
site, can have the paradoxical effect of rendering the region vulnerable to more serious injuries, communication
breakdowns, and utter chaos. On occasion, debris from the repair site gets washed into the waterways, creating
problems downstream. In addition to the damaging by-products they produce, H. pylori also are armed with
toxins of their own that alert Somas Nodal Sentry to their presence. The ensuing battles often cause even more
harm. When especially desperate, H. pylori can transform the Nodal Sentry into berserk mutants, turning them
against Somas most
protected regions.
But H. pylori is not
entirely to blame. They are
weak-minded, suggestible
creatures. Their violence is
mostly ordered by other Lords,
who turn the peaceful creatures into
ruthless enemies of Soma through
persuasion and threats.
32
Klebsiella pneumoniae
From the northern seas to the eastern deserts, K.
pneumoniae can be found throughout Soma, as well
as being common to the uninhabited regions. They
often live peacefully among the local inhabitants
but should a regions defenses be weakened for
any reason, often from too-frequent banquets and
bacchanals, they seize the opportunity to devour
resources, causing extensive damage to nearby forests,
filtration systems, dwellings, and more.
Alias: Klebsiella
Nemeses: Ceftriaxone, Cefepime,
Ceftazidime
Affinity: Infirmaries
Many are peaceful.
Choke, suffocate, groin strike

K. pneumoniae invasions can leave the land barren
and black, save for the bloody remains of casualties
Breathe nitrogen, fiber shields,
that ooze from the war-torn forest after the savage
adaptive defenses, copy armor
warriors take their leave. Unlike most Lords, K.
pneumoniae have the unusual ability to utilize
atmospheric nitrogen, allowing them to generate valuable resources from a normally useless gas and to
survive in the absence of oxygen. Their sugary shields, comprised of both common LPS fibers and similar
K fibers, protect them from being killed and eaten by Somas natural defenders. They also have begun to
evolve resistance to many of the Apothecaries attacks, copying defensive techniques from their fellow
Lords. Ciprofloxacin, for example, once a formidable nemesis of K. pneumoniae, is now often ineffective.
Alternative strategies are needed to supplement the
Apothecaries efforts, and are still sometimes
not sufficient.
33
Listeria monocytogenes
Legionella pneumophila
Aliases: Legionnaire, Pontiac, Firelung Crab
Alias: Listeriosis
Nemeses: Levofloxacin, Azithromycin
Nemeses: Ampicillin, Penicillin
Affinities: aquatic environments, infirmaries
Affinities: Infants, pregnant women, the

elderly, fruit, soft cheeses
First discovered in 1976 after killing

Legionnaires attending a gathering.
Rend flesh, heat wave, manipulate fluids,

psychic shock, dizzying blast, confuse,
cause seizures
Suffocate, heat wave, manipulate

fluids, destroy appetite, create
fatigue, rend flesh
There are 13 different L. monocytogenes armies

Endure harsh conditions
that pose a threat to Soma. They can survive a
wide range of climates, permitting their affiliation
with a wide range of creatures traveling through Buccal Bay and the Marshes of Alimentum, including
Arctic species that hail from temperatures near zero degrees Celsius. They can also can withstand hot
temperatures and drought, conditions commonly experienced once inside Soma.
Survive traps
Legionella pneumophila are potentially murderous
Lords who are quick to take advantage of Somas
lush resources. They live and multiply within the
protection of giant jellyfish-like creatures that
reside in the water surrounding Soma, and search
for similar habitats upon entry to the land. They
allow themselves to be taken up by the bog traps
set by the Nodal Sentry, where they flourish,
basking in the protection of the hollow pockets
found near the bogs centers. They trigger the
decomposition of local inhabitants to supply the
nutrients they need for survival, and funnel those
nutrients into their temporary swampy homes.
They hunker down as they grow their armies,
sending out more than 200 scouts and soldiers
to foil efforts of the surrounding community and
destroy the mother colony.
However, warmer temperatures do affect their ability to move. As a result, they depend on the
inhabitants of Soma for transport, hijacking their highways and conveyances. They escape the marshes
by burrowing into surrounding banks, using the stalagmite-like horns that protrude from their backs
to gain purchase and pull themselves out. They make their way to the lands river and stream system,
stopping at local communities along the way to
scavenge resources and steal helpless infants.
L. pneumophila typically enter Soma aerially

through the Respiro Forest. They descend like
balloon spiders, then quickly scamper towards
the closest bog. Their presence can be relatively
benign, causing few, if any, disturbances beyond
the very immediate environment. But there are
plenty of more brutal strains of L. pneumophila,
that bring terror to all corners of Soma. Severe temperature swings sweep the land, and the Respiro
Forest reacts violently. General lethargy overcomes Somas pace of life, often with fewer fish coming
in through Buccal Bay to fuel the islands activities. Armies of L. pneumophila also can affect the
function of Sententia and disrupt the regular pace of Twin Heart City.
34
Listeria monocytogenes are the most dangerous

of the Lords that enter through Buccal Bay on the
backs of its aquatic inhabitants, and are most likely
to invade when the island is under attack by other
villains, and the Nodal Sentry is in disarray. If L.
monocytogenes successfully pass beyond Somas
boundary, there is a good chance that the island
world will not survive.
As they spread, the consequences of their

presence are vast, affecting the critical
functions of the Respiro
Forest, the Occulos, and
even Sententia. These Lords
also benefit from an unusual
level of communication and
cooperation among their own
armies, which they use to
coordinate full-blown
attacks that threaten to
end Soma once and
for all.
35
Methicillin-resistant Staphylococcus
aureus (MRSA)
Methicillin-resistant Staphylococcus aureus

(MRSA) are some of the most feared Lords
that haunt Soma. They evolved from their
close cousins, Staphylococcus aureus,
to evade the attacks of an entire legion
of Apothecary warriors. And if those
Apothecaries that can defeat the
dreaded creatures do not act swiftly,
MRSA have the power to end Soma entirely.
MRSA tend to invade through the Respiro Forest,
breaches in the Boundary Wall, or occasionally
the Southern Dam. They can live in hiding for
periods of time, without damaging the habitat or
Somas fauna, but they will attack at the first sign
of weakness in the Nodal Sentry. Within one to
two days, MRSA can spread throughout the land,
raising the temperature, slashing the Boundary
Wall, and leaving behind reddish time bombs. If
the bombs are not defused, they grow larger and
anchor themselves deeper into the wall, eventually
exploding and threatening the integrity of Somas
first and most critical line of defense.
Despite their often-violent presence, MRSA are
sometimes difficult for the Apothecary Army to
accurately identify, complicating the strategies
put in place against the threat. To be sure which
foe they are dealing with, the Apothecaries must
capture some of the creatures and study them under
controlled conditions. Unfortunately, given the fast
progression of the MRSA assault, there is not always
time to take such careful measures, and the Apothecaries
must often choose to launch their defensive front before
they are certain what they are dealing with.
Aliases: Mersa, Spawn of Missa,
Methicillin (Meticillin)-resistant S. aureus,
Oxacillin-resistant S. aureus (ORSA)
Nemeses: Linezolid, Vancomycin
Flay skin, toxins, heat
wave, time bombs
Adaptive defenses,
avoid detection
Lords of Pestilence | Stained Legion Grape Cluster
37
Mutans Streptococci
Aliases: Sugar Zombies
Nemesis: None
Affinities: Sugar
Despoiling touch, wrench-like grip,
melt stone
Endure harsh conditions,
regenerative repair, adhere
The mutans streptococci are undead creatures that haunt the shores of Buccal Bay, despoiling and
dissolving everything they touch. A miasma of sickness floats about them, and their very presence
causes changes to local environmental conditions, spreading decay and rot, and creating an alluring
environment for other vile creatures. They despise civilization, and attempt to destroy any structures
they come across, even if it takes years to accomplish. They can scale walls, adhering to the smoothest
surfaces with their gooey flesh. And their evil presence corrupts the will of others around them, turning
usually harmless beasts to their cause.
For an undead Lord, they are surprisingly social, and tend to gather into massive hordes. In these
gatherings the miasma around them congeals into a sticky, hideous substance, that serves to protect
them as they moan together in some kind of ancient rite.
When damaged, they can regenerate by transforming the decaying flesh of nearby carcasses and
absorbing the pieces into their own bodies in a ritual that is truly terrifying to behold.
Of special horror to children is their attraction to sugar, and many children suffer frightful and painful
visits from mutans streptococci after being too careless with their sugary treats. These terrifying
encounters are the most common Pestilence attacks on children of Soma. They have been known to
pluck the sugar-coated teeth right out of their screaming victims mouths. Each mutans streptococcus
carries these teeth on a gruesome necklace as proof of their crimes.
These Lords rarely kill, although if allowed to form massive hordes they can mount lethal attacks on the
Heart Cities, damming the very rivers and streams and causing widespread starvation and death. Mostly,
they spread decay and destruction, cause festering sinkholes, and pave the way for other opportunistic
Lords. The Apothecary Healers have not had much success against them in open battle. It is known that
their dissolving powers are less effective against fluoride-reinforced walls, and ineffective against gold
or titanium, but they are never completely destroyed, and are a constant presence along the shores of
Buccal Bay, always returning in large numbers after every defeat. It requires constant maintenance to try
to rebuild faster than they can destroy. By clearing away the rot they leave, and constantly pushing them
back into the sea, however, it is possible to prevent them from gathering into their sickening hordes and
turning other beasts to evil.
38
Lords of Pestilence | Stained Legion Chained Sphere
Thanks to Kickstarter backer Kunio Chan, DMD, MAGD, for contributing information and funding for this entry!
39
Mycobacterium leprae
Aliases: Leprosy, Hansens disease
Nemesis: Dapsone with Clofazimine and
Rifampicin (not featured in this tome)
Affinities: Armadillos, mouse feet
Capture, disfigure, fast-acting acid,

paralyzing touch
Shape changing, waxy scales, acid
coating, avoid detection
Slow moving. Does not breed in captivity.
M. leprae have been tormenting the people of Soma as long as anyone can remember. They were one of
the first Lords of Pestilence ever discovered, and are greatly feared because of the agonizingly drawn out
suffering their victims must endure in captivity.
How M. leprae invade Soma is unclear. It is believed they either melt sections of the Boundary Wall,
or arrive by air, since they are usually found along the Boundary Wall, or near the northern edges of
Respiro Forest. They are masters of disguise, and can change shape at will. They are also very slow, thus
they must sneak up on victims unnoticed. They possess a somewhat unreliable paralyzing touch that
only affects very few potential victims, so M. leprae must sneak in the shadows and touch hundreds of
victims until it finds one who is susceptible. The horrifying conclusion of this behavior is that many have
been touched by M. leprae and dont even know it!
Once M. leprae find a victim, they assume an armadillo-like form and drag the poor soul back to
a hidden prison. There, hundreds of living captives are tortured and disfigured repeatedly, often for
decades, until the day comes when a visiting Lord, a guest of M. leprae, finally picks one to slaughter
for its own needs. During this long captivity many prisoners lose limbs, either due to the sharp toothed
vermin that nibble on them in their sleep, or in desperate attempts to claw through the dirt and escape
with numb fingers. No matter how you look at it, it is a nightmarish scenario.
The fast-acting acid of M. leprae leaves distinctive markings on the Boundary Wall, and causes the
very stone to swell and buckle. This damage can weaken Soman defenses and allow other attackers to
invade. Somans are so terrified of M. leprae that whole areas become shunned by other Somans once
there is visible evidence of M. lepraes presence.
Fortunately, most Somans are naturally immune to M. lepraes touch, and only an unfortunate few
actually fall prey and are carried away. Hope that you are not one of them, for most Apothecary Healers
are unable to help.
Thanks to Kickstarter backer David Tomczyk for choosing and funding this entry!
40
41
Mycoplasma pneumoniae
Neisseria gonorrhoeae
Alias: Mycoplasma
Nemeses: Macrolide family, Doxycycline
Aliases: Gonorrhea, Gonococcus, the Clap
Affinity: Crowded environments
Nemesis: Ceftriaxone
Attract, charm, grappling hook, groin strike,

blindness curse, stunt infant, slash and burn,
contaminate, sterility curse
Affinities: Promiscuous adults, infants
Adaptive defenses
Suffocation
Once vulnerable, they can now resist the Penicillin,

Tetracycline, and Fluoroquinolone families.
Invisibility, small size, unrecognizable

skin, immunity to Beta-Lactam weapons
These destructive temptresses use their powers of sexual attraction to lure and charm their prey,
while stealing valuable secrets that aid in their evasion of the Apothecaries. They travel through Soma
by repeatedly launching grappling hooks at unsuspecting holdfasts to propel themselves across the
landscape, slashing and burning the earth and contaminating the soil as they go. Known also for having
a sweet tooth, they feast on Somas cocoa orchards while roaming the forests and countryside in search
of new victims.
M. pneumoniae are Somas silent hunters.

These miniscule phantoms lurk undetected
in the worlds forests, ever haunting Somas
peaceful communities. Their elusory presence
once even led the Soman strategists to mistake
them for another class of foes altogetherthe
dreaded virusesa suspicion supported by the
irreparable damage they can cause to some
of Somas most vital settlements. Their ghostlike nature affords them the ability to slip
undetected through the city walls that often
block other Lords.
They despise Soman life and seek its extinction.

They are particularly cruel to Somas newborn
infants, using curses to stunt and blind them.
Furthermore, their sterility curses can prevent
future generations of Somans from ever
being born, jeopardizing the survival
of Soma itself. Truly, the dire threat of
these witches requires a concerted
effort by all Somans to prevent their
numbers from spreading.
M. pneumoniae tend to invade the Respiro

Forest from the northern shores, and can
establish themselves there, or enter the
Vasculature Rivers and travel throughout the
land. Once they replicate themselves into large
enough armies, they can inhibit the forests
ability to filter the air, causing serious damage
to Sententia and Twin Heart City. They even kill
the flora and fauna of the regions they infect.
But M. pneumoniaes greatest defense is their
peculiar skin, which makes them hard to
locate or even recognize. Their skins unique
composition also makes them immune to
the Beta-Lactam weapons of Penicillins and
Cephalosporins. Although there are a handful
of Apothecaries that can conquer the beasts, M.
pneumoniae do not relent without a fight. To achieve their diaphanous guise, they have given
up the ability to sustain themselves without a host, thus their battles to remain in Soma are a
fight for their own survival.
42
Lords of Pestilence | Unstained Legion Filament
Lords of Pestilence | Unstained Legion Diplococci
43
Neisseria meningitidis
Nocardia asteroides
Aliases: Neisseria Men, Meningococcus
Aliases: Nocardiosis, Nocardian Mimic
Nemeses: Ceftriaxone, Penicillin
Nemesis: Trimethoprim-Sulfamethoxazole
Affinities: Spit
Affinity: Soil
One of the Great Imitators.
Psychic blast, confuse, poison,

bombs, spread lethargy
Mimic other Lords attack styles
Mimic, cling
Web-like cords, mimic, misdirect
N. meningitidis are cerebral sorcerers who

target the residents of Sententia and their lines
of communication that coordinate all of Somas
activities. They enter through Buccal Baybut
rather than continuing down to the dam and into the
marshes, N. meningitidis veer down the Pharyngeal
Path, which shortcuts to the southernmost portion of
the northern forest. They can also enter the northern
forest directly, just north along the Boundary Wall
from the bay.
Nocardia asteroides are wicked foes that can wreak

havoc on nearly every inch of Somas habitat. They
can live harmoniously around the rim of Buccal Bay,
but when they begin to meander inland, particularly
to areas already under attack by other Lords, the
consequences can be devastating. They are notorious
for disguising their attacks by mimicking the effects
of other Lords, confusing the Apothecary Army and
buying time as the wrong suspects are hunted. They
also possess a rare ability to leave behind a thick web
of cords, and these cords play a large factor in their
successes, obstructing the activation of Somas valiant
defenders.
Occasionally known to be peaceful residents of this

region, N. meningitidis are more often deleterious.
They creep into the surrounding communities,
deploying an array of weapons that serve to stun
and damage the locals. One poison they release
kills inhabitants of the waterways, cutting off the
land from vital nutrients. They also release powerful
bombs that block the Nodal Sentrys counterattacks,
buying time for its armies to multiply.
N. meningitidis can cause lethargy throughout
the land, unstable temperatures, and pain and
dysfunction among Sententias citizens. Such effects
can resemble attacks by Haemophilus influenzae and Streptococcus pneumoniae, but the Apothecary
Army must be wary; if not quickly recognized for the threat that it isand responded to appropriatelya
successful N. meningitidis invasion could spell the end for Soma. Due to this danger, the Apothecaries
sometimes act preemptively to prepare for encounters with N. meningitidis. If word reaches Sententia that
a nearby island has experienced an invasion, the Apothecaries will send in a hero to guard Soma. The
Apothecary strategists have also devised a less violent mimic of N. meningitidis, that they can send in for
simulation battles with the Nodal Sentry, in order to prepare the valiant defenders for a real attack.
44
Lords of Pestilence | Unstained Legion Diplococci
They commonly attack Respiro Forest, summoning

minor earthquakes and sudden windstorms in the
region, and can choke the lands supply of the
Vasculature Rivers life-giving magic. From there, N.
asteroides often make their way to Twin Heart City,
burning the city limits as defenders gather to guard
their inhabitants from the impending menace. The
opportunistic Lords can also travel to Sententia, where
they ravage the citizen residents, and threaten the
countrys harmonic alliance. They have also been
known to damage the Occulos, and they can create
gashes in the Boundary Wall that expose the world to
other fearsome intruders.
Protecting Soma from such a formidable enemy is no easy task. N. asteroides can thrive in a wide range of climates,
and once they take hold throughout the land, they are often a lasting presence. Though many Apothecaries are often
called to fight this menace, it can take up to a year of constant defensive efforts to finally defeat
the persistent N. asteroides.
45
Pasteurella multocida
Aliases: Fangbeast of the Pasture, Avian
Cholera
Nemeses: Cefepime, Ceftazidime,
Amoxicillin/Clavulanate, Penicillin
Affinities: Birds, chickens, swine, cattle,
buffalo
Has a rodent-like smell.
Animal capture, poisonous bite,

claw/scratch, toxins, sabotage
Protective force field, rune magic
P. multocida are fearsome were-creatures that typically

make their home among the birds and beasts outside of
Somabut when the impulse strikes, they have many
means to invade. With their powerful claws, they can
tear their way through the Boundary Wall, and have
even been known to use winged beasts to infiltrate the
Respiro Forest, leaping from bird to bird as they murder
each one. They can also swim into Soma through Buccal
Bay or Fecal Inlet.
Like their distant cousins Haemophilus influenzae, they
organize into six Runic Battalions, each identifying with
different Runes of Power. At least two of these battalions
have developed a protective force field, although
fortunately it is not very strong.
In combat, they use their claws to cling fast to victims,

who they then bite with their poisonous fangs. Left
unchecked, they can infiltrate Sententia, Twin Heart City, and the Skeletal Mountains, leaving a trail of
suffering in their wake. And while they murder with abandon, for sustenance they actually devour iron and
salt, not flesh. Soman trackers find them by following their distinct, rodent-like smell. Fortunately, they are
no match for most Apothecary warriors once their presence has been discovered. Although they possess
considerable skill at sabotaging the defensive constructs of the Nodal Sentry, elite Apothecary forces
learned long ago how to defeat this angry beast.
46
Proteus mirabilis
Proteus mirabilis are unusual in their swift, swarming
attacks. They travel synchronously through the Marshes
of Alimentum, and occasionally across the land, like a
tight-knit flock of birds or a school of fish. The effect is
like the amoeboid movement of crowds in a large city,
and the devastation they leave in their path quickly takes
its toll on Soma.
Alias: Protean Worshipper

Nemeses: Ampicillin, Amox/Clav,
Ceftriaxone, Fluoroquinolones, TMP-SMX
Has a fishy odor. Many are peaceful.
P. mirabilis can actually can live harmoniously within the

Swarm, alchemy, crystals, manipulate
Marshes of Alimentum. But when they reach damaged
fluids, Lacta Mace
areas of Somas Boundary Wall, or occasionally Respiro
Forest, they can cause significant damage. The most
Adaptive defenses
common site of P. mirabilis battles, however, is in the
Caverns of Bladdara. The Proteus mirabilis access the
caverns when they are ejected from the Fecal Inlet and reinvade just nearby close to the boundary wall. Just like
the vicious E. coli troops, they backtrack through channels and the southern exit and enter the Caverns. Once
there the P. mirabilis change the water chemistry of the Caverns. Indeed, alkaline water is a strong indicator that
P. mirabilis is somewhere nearby. If the Lords are not banished quickly, they begin to track farther upstream and
sculpt crystals that aggregate into massive staghorn effigies, that can cause severe damage to these channels, or
even block the waterway altogether.
These Lords can also move up from the caverns and the channels to Somas water filtration plant, where they
can cause severe upset to the entire Soman system, generating currents that reverse the waters flow through
the marshes and purging the Southern Dams contents through Buccal Bay. Fortunately, many Apothecaries are
successful at containing P. mirabilis. Once the Lords are identified, the appropriate warrior can be sent into battle,
andbarring the presence of other Lords of Pestilenceshould be able to eliminate the offenders within seven
days time.
47
Pseudomonas aeruginosa
Aliases: Pseudo-Fire Nightmare, Hotta Brash
Nemeses: Piperacillin, Ticarcillin, Cefepime, Imipenem
Affinities: Infirmaries, scorched earth, battlefields
Has an iridescent glow and a sweet odor.
Toxins, groin strike, flay skin,

suffocate, Lacta Mace
Armor, secrete pigments, eat fuel,
endure harsh conditions
The fearsome Pseudomonas aeruginosa are a widespread menace to Soma. Able to feast on
a wide variety of organic substances, they can be found in nearly all of Somas habitats, both
terrestrial and aquatic. They can tolerate low-oxygen environments such as bogs and aquatic
trenches, as well as locations that would be toxic to Apothecaries and Lords alike, such as black
bubbling crude. Not only can P. aeruginosa endure harsh conditions, they can even adapt to
entirely novel habitatsand their wide reach makes them a persistent threat to the land and its
inhabitants, particularly the sick or injured. They are the epitome of opportunistic; they almost
never attack the strong, but any sign of weakness is like a lighthouse to them a beacon that
guides the sordid Lords to their next location. They have been known to ruthlessly colonize
Respiro Forest, Fecal Inlet, or any part of Somas filtration system. After establishing themselves
within an area, they begin starving the communities and destroying defensive walls and
protective boundaries, leaving their victims ever weaker and more vulnerable. Their devastating
attacks can be fatal.
P. aeruginosa are readily identifiable by their iridescent glow and a distinct sweet odor. Their fiery
body armor is key to their resistance against the Apothecaries. In addition to providing physical
protection, the armor helps them use blunt force to penetrate Somas communities, scattering
local defenders to provide a clear path.
48
Rickettsia rickettsii
Aliases: Spotted Rock Demon, Black Measle,
Dermacentroxenus rickettsi
Affinities: Ticks, mice, rabbits, dogs,
children (not infants)
Leaves behind small pink spots that darken over time.
Reproduces slowly. Named after
Howard Ricketts, a scholar who studied these
Lords and even willingly battled them himself.
Heat wave, stab, bite, manipulate

fluids, tunnel through rock
Resistant to explosions
These rock demons tend to invade Soma during the warmer months of the year. They most
commonly ride in atop gruesome eight-legged mounts, that scurry en masse across the land
in such a way that sends a chill to any who witness it. Occasionally, R. rickettsii can also
tunnel through the Boundary Wall, or enter through Buccal Bay, washing in with dirty waves,
or hitchhiking on unclean fish headed for the Marshes of Alimentum. Regardless of their
point of entry, R. rickettsia eventually make their way to Somas rivers and streams, where
they latch onto the banks using the sharp, rock-like protrusions on their backs. They tunnel
their way ashore, causing disarray among the ordered grasses and woody vegetation that
maintain the integrity of the stream and river beds, leaving Somas vital water-exchange system
compromised. Once ashore, the demons take time to gather and multiply their forces before
spreading slowly across the land, leaving behind telltale signs.
The initial invasion can cause a rise in temperature and turbulence in the marshes, sometimes
including a flow reversal to eject the contents of the Southern Dam, and slow the intake
through Buccal Bay. Within a day or two, Somas Boundary Wall begins to show classic
signs of a R. rickettsia infestation, with small pink wounds appearing first at the outermost
extremities. Over time, these gashes darken, and work their way across the entire wall. Finally,
if the Apothecary Army does not quickly identify the invasion and respond, more severe
outcomes can ensue, including disrupted flow to the lower half of the Marshes of Alimentum,
severe pain throughout the land, and general unrest in Respiro Forest, Sententia, and other
life-supporting Soman cities. Without Apothecary intervention, R. rickettsia can even lead to
the lands demise.
50
37
Salmonella typhi
Shigella
Like their hereditary cousins E. coli, Shigella Lords are
loathsome killers that slowly suck the life out of Somas
gentle creatures, disrupting the normal biological
processes that keep the land and its inhabitants healthy
and hydrated. Their attacks are particularly dangerous
to Somas young, and can be lethal without Apothecary
intervention.
Aliases: Typhoid Mary, Salmonella enterica,

serovar Typhi
Nemeses: Ceftriaxone, Fluoroquinolones
Affinities: chickens, swine, cattle
One of more than 2,000 close relatives,
all considered subspecies of Salmonella enterica.
Alias: None
Nemesis: Fluoroquinolones
Affinities: Infants
A close relative of E. coli.
There are seven different battalions in the Shigella legion,

Shigellosis, manipulate fluids,
each capable of profound devastation. That said, as few
dehydrate, hijack
as 100 individuals are capable of invading Somas weaker
regions and wreaking havoc on the land. They linger
Adaptive defenses, escape restraints
around the peaceful populations until they are noticed by
the local residents and taken to a holding facility. There,
they release biological compounds that rupture their restraints, freeing them into the heart of the community,
where they quickly disrupt its healthy balance. They tear apart the earths crust, allowing subterranean fluids
to ooze forth, flooding the land and mutilating the terrain.
Poisons, invasin spray, Lacta

Mace
Adaptive defenses, double-layer
force field, acid resistance
Salmonella typhi are wicked creatures that torment
Soma as much by spreading fear as by the physical
devastation they can inflict. Though their beginnings
remain mysterious, S. typhis arrival in Soma was quickly
recognized as a crushing blow to the Defenders and the
Apothecaries valiant efforts to keep peace in the land.
Because few Shigella species are capable of traveling on their own, they take advantage of Somas mobile
creatures by hitchhiking and hijacking. They drug their locomotors, and force the innocent animals to carry
them to new and uncharted territories, where they can begin the
nightmare of infection all over again.
S. typhi invade primarily through Buccal Bay, sometimes

also sending armies aerially to Respiro Forest. They first
target the Marshes of Alimentum, where they grow their
armies in preparation for a widespread assault. After a
fortnight and a half, they burst through the banks of the
marshes, spilling into the surrounding territories and
festering in the Waste-Processing City and Hemofactory Outpost, as well as throughout Somas rivers. Their strikes
cause intense wildfires, disturbances in the Southern Dam, and extreme pressure in Sententia, which disrupts the
citys processing power.
S. typhi have many battle tricks. They spray a chemical called invasin, which makes dumbfounded Soman
inhabitants invite them into their homes. They surround themselves with a distinctive double-layer force field, and
carry with them a poison that paralyzes the Defenders preventing Apothecary bombing campaignsremoving
one of the Apothecarys most relied-upon tactics. Furthermore, S. typhis weapons also include endotoxin, a
poison typically wielded by Lords of the Unstained Legion, and a black steel sword that helps them battle their
way through Soma.
Fortunately, many Apothecaries are swift and effective at eliminating this menace, particularly if their invasions
are noticed quickly. Successfully banishing the wily Lords should allow a full recovery for Somas affected regions.
However, like so many of the Pestilence Armies, S. typhi need the land for their survival, and thus are not likely to
go down without a fight.
52
53
Staphylococcus aureus
S. aureus are a growing threat to Soma,
mostly due to their ability to adapt and
evade the Apothecaries strategies. They
are the ancestors, for example, of the
terrifyingly elusive MRSA and VRSA,
two of the most powerful Lords.
And S. aureus themselves are no
easy enemy. While they can
sometimes live peacefully along
Somas Boundary Wall, in the
Northern Forest, and occasionally on
the beach of Buccal Bay, they can
be just as threatening as their more
evolved cousins.
They are known to turn violent on the
Boundary Wall, for example,
puncturing the rocks as they
charge up and down the
walls. Even more sinister
is when they move inland,
infiltrating the Respiro Forest,
Sententia, Twin Heart City,
and the Skeletal Mountains,
causing widespread damage
throughout the land. If the Apothecary
front fails to restrain these invaders,
island-wide disease can ensue,
leaving the land dark and
decayed, devoid of life.
Alias: Golden Missa
S. aureus live and travel in

familial herds, with offspring
staying near their parents to form small
cluster armies. Their golden hue,
while beautiful, is actually key to
their foreboding presence within
Soma. The yellow pigment of their
armored skin serves to absorb the
toxins of the Defenders arrowheads,
soaking up the poisonous sap before it can
penetrate into the monsters bodies. S. aureus also
have several toxins of their own, which they expel during
battle to bring Somas inhabitants to their knees.
Nemeses: Oxacillin, Cefazolin

The name aureus means golden in Latin.
Some are peaceful.
Shigellosis, manipulate fluids,

dehydrate, hijack
Adaptive defenses, escape
restraints
55
Staphylococcus
saprophyticus
Staphylococcus epidermidis
Alias: Yuti of the Honey Moon
Aliases: Skin Traitor,

Staphylococcus albus
Nemeses: Cefazolin, Levoflaxacin, Oxacillin, TMP-SMX,

Amox/Clav
Nemeses: Cefazolin, Oxacillin,

Vancomycin
Affinities: dead animals, cattle, sheep, swine, women
Affinities: Smooth surfaces,

infirmaries
Inhibits the presence of other Lords of Pestilence.
When clustered together as a colony, has a

white glow. Normally peaceful.
Flay skin, heat wave, lethargy,

biofilm, slime, sabotage
Adaptive defenses
Staphylococcus epidermidis normally
live in peace outside of Somas
Boundary Wall. But when the Nodal
Sentry is compromised due to the
relentless attacks of other Pestilence
armies, S. epidermidis can show its
vicious side, flaying the skin of its
victims and leaving behind a noxious
slime. When the Boundary Wall is
being repaired they can cluster tightly
together and then attract other Lords to
join the effort, collectively forming an
impenetrable barricade of Pestilence
agents. In this formation, Apothecaries
cannot reach the deepest individuals in
the living wall, allowing the evil armies
to rest and replenish their resources.
They can also enter Soma up the channel to the Southern Exit, stowing away undetected on vessels
involved in channel maintenance, and contaminating the channel by spreading a poisonous biofilm
that is so difficult to remove that maintenance crews often have to undo their own work and start over
from scratch.
Acid resistance, scales, consume

waste
This sultry Pestilence creature has a
predilection for torturing young female
victims. These devious creatures take
up residence in the lower channels
near the Caverns of Bladdara, latching
onto its walls with serpentine tentacles,
disrupting its flow and causing severe
pain with their razors to inhabitants in
the water and near the shore. Special
scales on their lower bodies allow
them to thrive in the varying acidic
conditions of the lower channels. They
can survive in high concentrations of
waste near the southern exits, and even
consume them for sustenance when
necessary. They particularly enjoy
feasting on rotting carcasses.
Traveling in close-knit groups, they find
their way to the Caverns of Bladdara
via multiple routes, but are notorious
for swimming up from the exits and
burning the shores as they go. They also
travel to Somas filtration center, which
only serves to further aggravate the
ebb and flow. Their efforts of sabotage
often involve hurling stones that either
dam the waterways or cause a buildup
of sediment that can leach into the
river systems, upsetting the ecological
balance. S. saprophyticus are selfish,
however, and desire Soma only for
themselvestheir presence actually
inhibits other Agents of Pestilence, a
trait that the Apothecary Healers have
not failed to notice and seek to use to
their advantage.
Their attacks can outlast even the best efforts of Apothecary Warriors, and the effects can be
devastating. They aggravate the suburban residents of Twin Heart City, causing changes in temperature
and general lethargy throughout the land. The rivers and streams of Soma begin to dry up, failing to
carry the necessary nutrients to the islands inhabitants.
56
Tentacles, groin strike, hurl stones,

burn, razors, sabotage
57
Aliases: Strep pneumoniae, Respiro Demon,
pneumococcus
Nemeses: Penicillin, Haemophilus influenzae
Suffocate, slash, piercing scream,

burn, contaminate, psychic squeeze,
psychic bubble, Lacta Mace
Adaptive defenses
Many are peaceful. PRSP, a more

dangerous relative, can resist Penicillin.
Despite its name, these Respiro Demons can

attack more than just the Respiro Forest. They can
wreak havoc on a wide range of systems in Soma,
including the land surrounding Buccal Bay, the
Auditoria, and even Sententia. They are similar to
other cocco-demons in their weakness to certain
Apothecary potions made of bile or optochina
trait which is one of the few things that more
than 90 different battalions of S. pneumoniae
have in common. Each battalion differs in the
intensity and frequency of its attacks, as well as its
vulnerability to various Apothecary defenses. Thus,
each attack on Soma must be carefully studied
before planning a counterattack.
S. pneumoniae are an ancient Soman menace,
having plagued the country for more than a
century. Like many Lords of Pestilence, they
strike as soon as the opportunity presents itself.
Fortunately, they are relatively easy to capture
and information from captured S. pneumoniae
prisoners has been valuable to the Apothecary
efforts over the years, revealing methods of
intelligence-sharing among other Pestilence
agents. But that doesnt make them any less
threatening.
58
Streptococcus pyogenes
Choke, ray of blistering, ray of dizziness,
heat wave, flay skin, devour flesh, drive
Nodal Sentry mad, toxins, shock
Aliases: Strep, Flesh-Eating Demon, Scarlet

Fever Demon
Nemeses: Penicillin, Cephalosporins
These demons can infest Somas entire perimeter,
and are commonly found in Buccal Bay and
along the Pharyngeal Path, where they stain the
whole area scarlet red. They are surrounded by
a protective chain that shields them from the
counterattacks of the Nodal Sentry, preventing
their capture and demise, and they carry a large
arsenal of weapons that can inflict moderate to
severe damage in the areas they occupy. The
gravest S. pyogenes attacks take such a toll on
the Boundary Wall that parts of it begin
to crumble, disintegrating into
the sea surrounding the island.
This insult to Somas first line
of protection against other
Pestilence invaders renders
the world vulnerable to
unpredictable attacks, for which
the Nodal Sentry is not
prepared.
Protective chain
Some battalions of S. pyogenes also carry a suite of
poisons that can spread the Lords wrath beyond
Somas boundary. And these Pestilence agents can
even inflict harm after they depart, by using their
Rune of Power to leave behind an evil presence
that turns Soman protectors against Soma. The
Nodal Sentry, seemingly driven mad by the terror
of the S. pyogenes invasion, begins to attack the
filtration system, the Skeletal Mountains, and
even Twin Heart City, threatening to finish the job
started by the invasion. Fortunately,
S. pyogenes are no match for the
heralded Apothecary warrior
Penicillin, if their invasions are
caught early enough.
An interesting antagonistic relationship exists

between S. pneumoniae and fellow Pestilence
agent Haemophilus influenzae. While either
group can reside in the Respiro Forest on their
own, these two cannot peacefully coexist, and
Somas Nodal Sentry seems to recognize some
compelling interactions between the two. Though
the details remain murky, it is clear that there is no
love lost between these two agents, and Somas
natural defenses are often able to take advantage
of their quarrels to extinguish the invaders before
they can inflict widespread damage.
Lords of Pestilence | Stained Legion Lancet Diplococci
Lords of Pestilence | Stained Legion Chained Sphere
59
Treponema pallidum
Aliases: Syphilis, Yaws, Pinta, Bejel
Nemeses: Penicillin, Azithromycin
Affinies: Snakes, promiscuous adults
One of the Great Imitators. Its powers are
not well understood.
Rend flesh, deform, swell, blind,

cause madness
Treponema pallidum are crafty temptresses who

penetrate Somas Boundary Wall by charming their
way onto boats heading for the Southern Coast,
adjacent to Fecal Inlet. Once inside Soma, these
sultry creatures swim upstream, undulating like
water snakes, from the harbor close to the Caverns
of Bladdara, searching for imperfections along the
shore through which they can infiltrate Somas
natural waterways and travel to the far corners of
the world.
No one knows exactly how T. pallidum manages

to wreak such devastation, but the results are
Evade detection
far from subtle. The wily temptresses can harm
Somas filtration systems and the camps of the
valiant Sentry, even making their way to the Skeletal Mountains. If T. pallidum are not eliminated quickly
by the Apothecaries, damage begins to appear along the length of the Boundary Wall, with notable
deterioration around Buccal Bay and the Southern Coast. Their presence also can cause harmful rises
in temperature and a dearth of nutrients that enter through Buccal Bay to supply the land. Eventually,
T. pallidum will even permeate Twin Heart City and Sententia, where they
can disrupt the rhythm of Soman life and affect drastic alterations in Somas
typically warm and inviting collective persona. While a handful of
Apothecaries can successfully eradicate T. pallidum, the Lords cannot
be captured, and thus much remains unknown about how they inflict
such destruction, making
it nearly impossible
for Soma to
prepare for
such attacks.
60
Vibrio cholerae
Vibrio cholerae are poisonous Lords that excrete a
potentially lethal toxin into Somas alimental channels,
causing massive and frequent surges down the
waterway. There are several types of V. cholerae that
can induce such turbulence to Soma, and they enter
Buccal Bay freely, in the water or on the ships of
Somas fishermen. After they gain entry, they settle into
the lower Marshes of Alimentum, where they burrow
into the banks. There, they build their armies and, with
the help of an autonomous shuttle, spread the recipe
for their illness-inducing toxin.
Aliases: Cholera, Blue Death

Affinity: Shellfish
Manipulate fluids, toxins, dehydrate
Burrowing, filamentous appendage
Finally, when they sense that enough troops are ready to produce a sufficient amount of toxin to launch an
effective strike, they release their poison, causing the banks of the marshes to swell and sending floods of
water out Fecal Inlet and occasionally back up through Buccal Bay. The sudden outflow can leave the land
dry and weak, and the people dying of thirst. After they have unleashed their poisonous assault, V. cholerae
re-enter the marshes and move on with the current to their next victim.
As the world continues to warm, these heat-loving Pestilence creatures attack more often and with greater
power. They are evolving, becoming even more vicious, causing severe damage across the island and
threatening to destroy it altogether. To counter this threat, the Apothecary Army must act swiftly when V.
cholerae strike, replenishing the islands waterways and expediting the delivery of key nutrients to villages
throughout the land.
61
VRE (Vancomycin-Resistant
Enterococcus)
Alias: Viyari
Nemesis: Linezolid
Affinities: Infirmaries, chickens
Formerly believed to be a Streptococcus Lord.
Usually peaceful. Can teach adaptive defenses
to others of the Stained Legion.
Mimic other Lords attack styles

Web-like cords, mimic,
misdirect
These demons are closely related to E. faecalis, but are even

more devious. Like their close relative, they can thrive in
even the most uninhabitable places, but they are usually
too self-absorbed to bother attacking Soma, preferring
instead to spread their knowledge of battle tactics
to other Lords, and let their disciples mount
attacks in their stead. But those VRE with
a hunger for violence are among
They
the most feared Lords
are the most
that exist.
elite, most unstoppable
of the Enterococcus
demons, able to evade
the attacks of almost
every Apothecary warrior. If
left unchecked, they can set the
settlements along the Marshes of
Alimentum ablaze, and can even bring
an end to Soma entirely by spreading
contamination and fire. The few mercenaries
that can defeat VRE demand such high
fees that even escaping destruction leads
to economic ruin for Soma. As such,
terrified Somans burn offerings to
the Enterococcus demons with
the hope of placating them and
staying in their good graces.
Lords of Pestilence | Stained Legion Cocci | Coccobacillary | Chained Sphere
63
Vancomycin-resistant Staphylococcus
aureus (VRSA)
Alias: The Dreaded Versa
Nemesis: Linezolid
Extremely rare.
Share weapons, fire-breathing

Adaptive defenses,
share/copy armor, thick skin
This fearsome creature represents the pinnacle of Pestilence evolution. Only a
handful of Apothecary warriors have the ability to destroy itbut perhaps most
frightening of all is its ability to train other Agents of Pestilence how to adapt and
survive under duress.
Vancomycin-resistant Staphylococcus aureus (VRSA), the youngest group of S.
aureus dragons, has learned to evade Vancomycin, the Apothecary warrior of last
resort, which leaves few options left for Soma. The first VRSA army assembled in
2002, when a MRSA liege and a band of E. faecalis crossed paths in a nearby land.
By way of an autonomous messenger, some of the E. faecalis army slipped their
Vancomycin antidote to their MRSA allies, and a new breed of S. aureus was born,
one that could resist the attacks of both Methicillin and Vancomycin, two of the
most effective Apothecaries defending Soma.
Fortunately, VRSA attacks are extremely rare, and there have been only 10
known VRSA sightings ever recorded. There have also been sightings of VISA
(Vancomycin-intermediate Staphylococcus aureus), another MRSA offshoot that
has attained the Vancomycin antidote, but uses it less effectively. VISA is also
a threat, albeit also rare. These dragons have such thick skin that Vancomycins
weapons cannot penetrate it. VISA and VRSA not only threaten to inflict direct
damage to Soma, they also serve to confuse the Apothecary Army, which requires a
thorough understanding of Pestilence agents vulnerabilities to launch an effective
counterattack. When both MRSA and VRSA infections are present, Apothecary
strategizing can become nearly impossible.
Thus, while VRSA and VISA attacks on Soma are still infrequent, they have the
potential to become the first Lords of Pestilence to finally outwit the Apothecary
Army once and for all. As more and more VRSA armies are assembled, the scales of
battle might well begin to tip away from the good and the healthful.
65
Yersinia pestis
Aliases: Plague Beast, Black Death,
Justinians Monster
Nemesis: Streptomycin
Affinities: Rats, fleas
Telltale signs include bloody saliva
and black marks.
Wave of heat/frost, swell, torture,

psychic burn, trigger quakes, suffocate,
cause madness/lethargy, groin strike,
sticky excretion, potions
Yersinia pestis are one of the most ancient scourges to haunt Soma, and have been
responsible for the deaths of countless other worlds in the deep past, even before the
Apothecary Healers began offering protection to Soma and other lands. In fact, these
Pestilence agents were only discovered centuries after some of their most horrific
killing sprees and, over the last few decades, the breadth of their wrath has slowly
been revealed.
When Soman scouts visited a string of barrier islands that had fallen victim to a
mysterious villain some 600 years ago, for example, they found the remains of some
Y. pestis beasts preserved in the rocks surrounding the islands entry bays, leaving
little doubt as to the cause of the tragedy. Y. pestis can be so devastating that some
lands have gone so far as to purposefully release the Pestilence agents on enemy
territories as a form of warfare.
Yet these beasts still lurk around Somas perimeter, feasting on giant marine rodents
and breaking through the Boundary Wall whenever the vermin come ashore to
nest on the beaches. They synthesize a sticky excretion that allows them to scale
the wall and enter Somas border towns. They also produce a potion that eliminates
blockages from Somas waterways, in order to speed up the rate at which they
infiltrate the rest of the land, where they are skilled at evading raids by Somas Nodal
Sentry and can cause widespread damage. Thankfully, however, now that Y. pestis
have been definitively identified, the appropriate Apothecary counterattack can
usually protect Soma from extensive damage.
66
Apothecary Families
Aminoglycoside
Cephalosporin
Glycylcycline
Macrolide
Carbapenem
Lincosamide
Oxazolidinone
Tetracycline
Carboxypenicillin
Aminopenicillin
Chloramphenicol
penicillin
Nitroimidazole
Glycopeptide
Ureidopenicillin
Monobactam
Fluoroquinolones
Sulfonamides
Amoxicillin/Clavulanate
Nom de Guerre: Amox Clav
Age: Mature
Clan: (Amox) Penam
Family: (Amox) Aminopenicillin (Clav) Clavam
Association: (Amox) Beta-Lactam (Clav) Anti-Lacta Mace
Fighting Style: Deadly force
Specialty: P. multocida, P. mirabilis, Staph saprophyticus
Anti-Lacta Mace shield

Amoxicillin is a valiant Beta-Lactam warrior who has slain the Lords of
Pestilence that haunt Soma for more than 40 years, and has become a hero
often called into battle. He is effective against a range of Pestilence invaders in
various regions of Soma, including the Boundary Wall, the Northern and Respiro
Forests, the Auditoria, and the channel to the Southern Coast. Unfortunately, like
the rest of his Beta-Lactam comrades, he cannot withstand the Lords who wield
the Lacta Mace.
To protect himself, Amoxicillin allied himself with legendary armorer
Clavulanate, in order to design a living shield that could effectively block the
Lacta Mace. Armed and ready, Amoxicillin returned to battle stronger than ever.
At present, he is known to enter Soma through Buccal Bay, typically with an
influx of fish and other nutrient-rich aquatic animals, and disperses quickly and
efficiently to the center of the attacks. In fact, he is considered to be one of the
most effective of the Penam clan due to his swift penetration.
Unfortunately, Amoxicillin is not the gentlest Apothecary. He has been known
to disrupt the flow of the Marshes of Alimentum, sending water back out
through Buccal Bay or rushing south through Fecal Inlet. He can also irritate the
communities along the Boundary Wall. Such irritation is often indistinguishable
from a more threatening allergic reaction, in which an Apothecary triggers the
overreaction of the Nodal Sentry, which begin attacking the very land they serve
to protect.
74
Apothecary Healers | Aminopenicillin/ Clavam
Ampicillin
Nom de Guerre: Amp
Age: Elderly
Clan: Penam
Family: Aminopenicillin
Association: Beta-Lactam
Allies: Sulbactam, Gentamicin, TMP-SMX
Specialties: E. faecalis, L. monocytogenes, P. mirabilis
Cause stupor
Ampicillin is one of the chief seductresses of the Apothecary Army.
She uses the oldest trick in the bookstriking her enemies with
disarming beauty before cutting them off at their knees. Ampicillin
was only the second Apothecary to learn how to effectively
eliminate Stained Legion armies, and the first of the Penam clan
to develop broad-spectrum effectiveness. Mother of the great
Amoxicillin, many say she is still even fiercer than her son. She has
also proven herself more agile than clan elder Penicillin, with her
aerodynamic armor that allows her to efficiently penetrate to the
heart of battle.
Like the rest of her family, she kills Pestilence agents by blocking
their ability to grow and regenerate their armor, and is effective
against infections in the channel to the Southern Coast. She also
is deployed to dispatch the likes of Haemophilus influenzae,
Salmonella, and Listeria, although her charms have grown
old on many Lords, who have learned to resist her seduction.
Pseudomonas and Klebsiella are often able to survive Ampicillins
attacks, thus she is often paired with other Apothecaries in hopes
that a combination of strikes will be sufficient to take down the
offending Lords.
On rare occasions, Ampicillins alluring wiles can confuse the
Nodal Sentry, causing severe and damaging attacks on Somas own
residents. Usually, though, she is a peaceful combatant, and is as
critical to the Apothecary Army as any warrior ever was.
Apothecary Healers | Aminopenicillin
77
Ampicillin/Sulbactam
Azithromycin
Nom de Guerre: Amp Sulbactam
Nom de Guerre: Azithro
Age: Mature
Age: Young
Clan: Penam
Clan: Saccharopolyspora erythraea
Family: Aminopenicillin
Family: Macrolide
Association: Beta-Lactam, Anti-Lacta Mace
Association: None
Fighting Style: Containment

Specialties: L. pneumoniae,
Mycoplasma pneumoniae, T. pallidum
Cause stupor
Sulbactam plate armor
Block, crushing grip

Ampicillins twin brother, Ampicillin/Sulbactam, is
much more protected than his sister, equipped as he is
with the finest Sulbactam plates which were designed
specifically to withstand blows from the feared Lacta
Mace that many Pestilence agents carry. Ampicillin/
Sulbactam is thus often sent in to fight Lords who have
shown resilience in battle against his sister or other
Beta-Lactams.
Azithromycin, son of the great Erythromycin, is one of the

most commonly summoned Apothecaries. Like his mother,
he captures Pestilence agents and prevents them from
building the structures they need to spread and thrive
then watches them die slowly. Because of their similar
fighting styles, both mother and son are effective against a
similar range of Lords, although Azithromycin has a slightly
better track record against those of the Unstained Legion,
particularly Haemophilus influenzae. Furthermore, unlike
his mother, Azithromycin is not susceptible to the acidic
waters found north of the Southern Dam, and thus can
enter the Marshes of Alimentum unescorted, simplifying his
journey to the field of battle.
Ampicillin/Sulbactam enters Soma either through the

countryside, or by diving directly into the islands river
system. He can cause some disruption in the Marshes
of Alimentum, but is typically a gentle fighter. More
important, he is such an effective warrior against such a
diverse group of Pestilence agents that he is often sent
into battle when the culprit has not yet been identified.
He fights Lords along the Boundary Wall, in the
Respiro Forest, throughout the marshes, and elsewhere
throughout the land. He can take down ferocious
beasts such as Staphylococcus aureusand he is
undisturbed by the risks. In a rare display of weakness,
however, Ampicillin/Sulbactam is not effective against
Pseudomonas aeruginosa.
Azithromycin is capable of launching an effective

counterattack against a wide range of Lords, including those
who invade the aqueduct entrance at the rear of Buccal
Bay, the Occulos, and the Respiro Forest. He usually enters
through Buccal Bay and is often transported to the site of
infection by the Nodal Sentry. He is even sometimes sent
in preemptively, when the Nodal Sentry is compromised in
some way and the risk of a Pestilence attack is high.
Ampicillin/Sulbactam and his sister share a fraternal bond, and their similar strategies keep them close, even
when they are far apart, fighting infestations on opposite ends of Soma. Their family pride pushes them forward,
carrying them through even the toughest battles. Together, the Ampicillin twins are invaluable members of the
Apothecary Army.
78
Apothecary Healers | Aminopenicillin
Like most Apothecaries, Azithromycins protection comes

at a cost. His presence can disrupt the flow of the marshes,
causing them to discharge too quickly into the Fecal Inlet or
even reverse directions. Furthermore, he has been known
to put Twin Heart City at risk, particularly if it has already
been compromised.
Apothecary Healers | Macrolide
79
Aztreonam
Nom de Guerre: Aztreonam
Age: Mature
Family: Monobactam
Allies: Other Beta-Lactams, Tobramycin
Specialty: Unstained Legion only

Like others in the Beta-Lactam association, Aztreonam
can slay a wide range of Lords. She often is sent into
battle when the use of other Beta-Lactams would risk
more harm to the land than their protective efforts
can justify. She is only effective against the Unstained
Legion. Thanks to the unique structure of her BetaLactam weaponry, Aztreonam can also fight alongside
other Beta-Lactam warriors without incurring extra risk.
Unlike many Apothecaries, Aztreonam is not able
to enter Soma via Buccal Bay, but instead must
penetrate Soma aerially, through the Respiro Forest, or
aquatically, appearing on the banks of Somas rivers
and following their tributaries to the site of the battle.
Alternatively, she can spring from below, traveling
through the world in the vast stretches of countryside,
then moving to the nearest waterway for travel. Once
she reaches the Lords infestation, her quick strike is
powerful and effective. By inhibiting the Lords ability
to build their protective armor, Aztreonam renders
Somas nemeses vulnerable to attack.
80
Apothecary Healers | Monobactam
Cefazolin
Nom de Guerre: First-Gen Ceph
Age: Elderly
Clan: None
Family: Cephalosporins
Specialties: Staph aureus, Staph epidermidis, Staph
saprophyticus, Strep pyogenes, E. coli, P. mirabilis
Concoct potion, prevent regeneration,

destroy armor
The first-generation Cephalosporins are among the original
warriors who traveled from the wastelands, and provided
the stock for future generations. Cefazolin is the mighty
patriarch of the Cephalosporin family. He was once a
great warrior, defeating the Staph and Strep hordes with
ease, but many of those beasts have since evolved superior
defenses, while Cefazolin has weakened with age. This
legendary warrior is not retired yet, however, for he is still a
formidable weapon against S. pyogenes, E. coli, and agents
that turn violent on Somas Boundary Wall.
He defeats his enemies by concocting a special potion
that prevents them from repairing damage or generating
new body armor. This eventually causes Somas attackers
to literally lose their form, collapsing to the ground as their
insides spill out over the earth.
Mercifully, Cefazolin is one of Somas most peaceful
defenders, and rarely causes any collateral damage
to the land or its inhabitants. Like some of his fellow
Apothecaries, he usually is dispatched into Soma through
the river system or from underground somewhere in the
remote countryside, rather than the more common entry
point at Buccal Bay. He then follows the worlds tributaries
to battle, alongside Somas Nodal Sentry.
82
Apothecary Healers | Cephalosporin
Cefepime
Nom de Guerre: Fourth-Gen Ceph
Age: Young
Clan: None
Family: Cephalosporin
Specialties: K. pneumoniae, P. multocida,
Strep pyogenes, Strep pneumoniae, E. coli
Destroy armor
Cefepime is a massive warrior with a widely effective strategy.
Like many of his fellow Apothecaries, Cefepime targets the
creation and renewal of Pestilence agents armor, preventing
the reinforcing cross-linking that provides them with
protection against the Nodal Sentry. Cefepimes Beta-Lactam
axe swiftly and powerfully slices through Pestilence armies
of both the Stained and Unstained Legions. And importantly,
unlike many Beta-Lactam Apothecariesincluding his own
family, he is not susceptible to the agents counterattacks. His
powerful build also allows him to fully penetrate the defenses
of Unstained Lords, many of whom have been able to resist
the attacks of Cefepimes forebears. Due to his significantly
increased fighting ability, Cefepime can eliminate several notable
threats, including Pseudomonas aeruginosa and unusually strong
Streptococcus pneumoniae. He has been called one of Somas last
defenses against several serious human infections.
But like all members of the Apothecary Army, unleashing Cefepime against
Somas worst enemies is not without risks. Though his presence does not
increase mortality, he disrupts the flow of the Marshes of Alimentum,
irritates the region of the land where he first enters Soma, and causes minor
disturbances wherever he roams. More notably, he is associated with serious
deficiencies in Somas rivers and streams, which can result in leakage that
can drain the waterways, threatening to starve the islands communities of
their life-giving flow. As a result, Cefepime is usually only called into battle
when Soma is under siege by severe infections of the Respiro Forest or by
Pestilence armies that are resistant to most other Apothecary warriors.
84
Ceftazidime
Nom de Guerre: Ceftazidime, Third-Gen Ceph
Age: Mature
Clan: None
Specialties: K. pneumoniae, P. multocida,
H. influenzae, Strep pyogenes, E. coli
Increases likelihood of VRE invasions.
Prevent regeneration,
destroy armor
Anti-Lacta Mace spiked armor
Ceftazidime is a massive warrior in the Cephalosporin branch of the Apothecary Army. He is thirdgeneration, but is distinct from his cousins in his efficient destruction of Pseudomonas armies. He
has a single piece of armor that he wears on his left shoulder, like a pad with conical spikes pointed
towards the sky. This can protect him from the deadly swing of the Lacta Mace wielded by many agents
of the Unstained Legion. He is, however, less effective against Lords of the Stained Legion than his
generational brethren. As a result, Apothecary strategists usually only send Ceftazidime to fight a foe that
is his particular specialty.
Like all Cephalosporins, Ceftazidime defeats Pestilence armies by preventing their ability to grow and
repair their armor. Specifically, he inhibits the armors linkage, causing it to fall apart and rendering the
Lord susceptible to attacks by Apothecaries and Nodal Sentry warriors alike.
Ceftazidime enters Soma either through the waterways or from the countryside, from where he then
makes his way to the streams and rivers. Thence, he travels efficiently to the site of infection, and joins
the fray. He is commonly sent in to battle throughout Soma, including along the Boundary Wall, in the
Skeletal Mountains and the Respiro Forest, and along the channel to the Southern Coast.
86
Ceftriaxone
Nom de Guerre: Ceftriaxone, Third-Gen Ceph
Age: Mature
Clan: None
Specialties: K. pneumoniae, N. gonorrhoeae,
N. meningitidis, P. mirabilis, S. typhi, S. pyogenes, E. coli
Thiotriazinedione blade, destroy

armor, prevent regeneration
Ceftriaxone is one of the third generation of

Cephalosporins, a generation of warriors that have
nearly perfected their skills against the Unstained
Legion, yet have grown weaker against the Stained.
Still, these are very strong warriors who carry very
large swords.
Originally residents of Somas fungal forests, the
family has spread around the earth, courageously
taking on the Lords who threaten Somas survival.
Ceftriaxone is capable of defeating a great many
Pestilence creatures, and she can resist attacks that
devastate other Beta-Lactam comrades. Having
replaced the traditional acetyl sword with her new
Thiotriazinedione blade, her attacks are even
more effective. Since Neisseria gonorrhoeae have
developed new defenses, she is one of the only
Apothecaries left who can reliably take them down.
She targets the enemys ability to reconstruct its armor following injury, and
produce armor for future generations. Mercifully, her assaults are well
tolerated by the land and its peaceful inhabitants, causing only rare
and mild unrest. Very infrequently, the water that nourishes Soma
has been observed to drain from the hills after Ceftriaxone has
been unleashed on the Lords, leaving the land pallid and
emaciated. But it has never been proven that it is
Ceftriaxones attacks themselves that cause
this severe condition, and thus the fear
of such a loss has never stopped
the Apothecaries from sending
Ceftriaxone to the front lines.
88
Chloramphenicol
This old warrior is not as powerful as newer recruits,
yet he still has some fighting spirit left in him. While
younger, stronger Apothecaries may be sent into
battle first, Chloramphenicol is still called to fight
when their efforts failand, as one of the earliest
defenders of Soma, his experience is invaluable.
His excellent penetration of the walls of Sententia
(far superior to the Cephalosporins) still makes
him a preferred choice for Staph attacks on Somas
communications headquarters.
Nom de Guerre: Chloramphenicol,

Chlornitromycin
But he is dangerous. It is rumored that he once had

a connection to the Agents of Pestilence, and he
is notably insensitive towards Somas inhabitants.
The old curmudgeons recklessness can impair the
barracks of the Skeletal Mountains that produce
Somas Nodal Sentry and feed the waterways,
leaving Soma more vulnerable to other Pestilence
Lords. Thus, while he may effectively eliminate one
attacker, he simultaneously emboldens others.
Allies: Doxycycline, Cephalosporins,

Clindamycin, Penicillin
Due to safety concerns, he is no longer allowed

to enter through Buccal Bay, and he is not usually
called to service by island nations that can afford
better options. But since he is both cheap and
easy to summon, he is frequently called to
defend poorer realms. In addition, the Lords
of Pestilences increasing resistance to
newer defenders has renewed interest
in his abilities.
Apothecary Healers | Chloramphenicol
Age: Ancient
Clan: Streptomyces venezuelae
Family: Chloramphenicol
Association: None
Semi-retired. Ancestors lived among Streptomyces

venezuelae. Original mission was to fight
S. typhi, but the now almost universal
resistance of S. typhi has limited his power.
89
Ciprofloxacin
Nom de Guerre: Cipro

Age: Mature
Clan: None
Family: Fluoroquinolone
Association: None
Allies: Doxycycline, Cephalosporins,
Clindamycin, Penicillin
Specialties: B. anthracis, K. pneumoniae,
P. mirabilis, Shigella, S. typhi
Spiral thrust
Cipros fierce attack is unmistakable. She destroys the
ability of the Lords of Pestilence to multiply, inhibiting the
enzymes that enable them to breed and spawn more evil
into the world of Soma. Unfortunately, she is not always able
to restrict her vengeance exclusively to the Lords, and her
devastating blows can, at times, hurt the earth as well. Her
indiscriminate violence can hinder Somas ability to recover,
and do more harm than good if she is allowed to linger too
long. Worse, the Lords can learn to evade her wrath if she is
unleashed too often.
But she is a valiant warrior, having nearly perfected the spiral
thrust technique, and she is capable of keeping the Lords
at bay if her powers are used strategically. She shares many
qualities with her father, the late Nalidixic, who also struck
his victims at the level of their heredity, impeding their ability
to replicate. While this can be a dangerous mode of attack,
it has the advantage of being broadly effective against a
great many Lords. Indeed, Cipro is able to fell numerous
Lords of both the Stained and Unstained legions. She
can also team up with fellow Apothecaries to widen
the pool of enemies against which she is effective. If
Cipro is deployed sparingly, against the right victims
in the right circumstances, she can be an invaluable
competitor in the war that haunts Soma.
90
Apothecary Healers | Fluoroquinolone
Clindamycin
Doxycycline
Doxy has nearly perfected the art of ring-weapon
fighting. She is a slight warrior, but she packs a
punch, can effectively counter attacks by a wide
range of Pestilence agents, and is even deployed
ahead of time when the threat of invasion is high. It
is important that she not be deployed within Soma
for too long, however, as her presence can cause
vulnerabilities in the Boundary Wall.
Nom de Guerre: Clindamycin

Age: Elderly
Family: Lincosamide
Allies: Vancomycin, Cipro
She enters Soma through Buccal Bay, where again

her mere presence can aggravate the surrounding
land and creatures. Upon entry, she travels through
the Southern Dam into the Marshes of Alimentum,
sometimes disrupting their flow and causing unrest
along the banks, while using Somas waterways to
navigate to the site of battle.
Increases likelihood of C. difficile invasions.
The fire-throwing Clindamycin is an intimidating

Apothecary with the power to devastate a
number of Pestilence armies, particularly those
that thrive in close environments. His help
comes at a cost, however: he clears the way for
the inherently resistant Clostridium difficile that
flourish in the aftermath of Clindamycin battles,
disrupting the flow of the Marshes of
Alimentum and threatening to parch the island.
Clindamycin is also is known to be somewhat
careless with his fiery weapons, which,
unleashed in the wrong environment, can
cause direct damage around Soma, including
occasionally setting fire to Twin Heart City.
Nom de Guerre: Doxy

Age: Elderly
Family: Tetracycline
Specialties: B. burgdorferi, B. henselae, C. burnetii,
Mycoplasma, R. rickettsii, V. cholerae
Has a distaste for Soman food, milk,
certain minerals, and sunlight.
Ring weapons, block, crushing grip
Like the rest of the Tetracycline family, once Doxy has reached the battlefield, she attacks the offenders with
her ring weapons, which she is extremely skilled at using. She immediately begins to cut off the Lords abilities
to assemble their basic building blocks of life, and watches them
fall, one by one. She is an independent warrior who prefers
to fight on her ownbut for Somas most serious invasions,
she will work in tandem with other Apothecaries to rid the
land of evil forces. She should be deployed when Buccal
Bay fisheries are at low tide, as fish can interfere with her
ability to exit the marshes and reach
the battleground.
Despite these risks, however, Clindamycin is a powerful member of the Apothecary Army, and is often
called to repel invasions of the Respiro Forest, the Skeletal Mountains, the rock perimeter of Buccal
Bay, and the Boundary Wall. He can step in when Penicillin is not tolerated by the local communities,
and has been known to defeat the mighty MRSA (although many MRSA armies are developing effective
counterattacks to Clindamycins strike).
Clindamycin usually enters the land through Buccal Bay, though he can head directly to the embattled
areas of the Boundary Wall or dive directly into the worlds rivers and streams. He attacks the Lords by
inhibiting their ability to brew their poisons. In cases of the widespread panic of toxic shock, Clindamycin
is often teamed up with Vancomycin, who targets the Pestilence agents external armora lethal
combination attack for most Lord armies. Clindamycin can also affect the integrity of Pestilence armor,
rendering the agents susceptible to the Nodal Sentry.
92
Apothecary Healers | Lincosamide
Apothecary Healers | Tetracycline
93
Ertapenem
Nom de Guerre: Ertapenem
Age: Very Young
Clan: None
Family: Carbapenem
Fighting Style: Deadly force, last resort
Weakness: Carbapenem Mace, Metallo-Enhanced weapons.
Spells, prevent skin growth, resistant to

most varieties of Lacta Mace
Like her older relative Imipenem, Ertapenem belongs to the Carbapenem family and uses her
powerful sorcery to destroy Pestilence agents by weakening their skin until the villains insides
eventually spill out in a gory mess. Unlike Imipenem, who fights with a partner for protection, she
fights alone, untroubled by the powerful Lacta Mace that some Lords wield, although like others
in the Carbapenem family, Metallo-Enhanced weapons and the Carbapenem Mace are her achilles
heel. Fortunately such weapons are still very rare.
With her pyrrolidine ring for conjuring spells, she is able to defeat an impressively wide variety of
both Stained and Unstained villains, almost as many as Imipenem can, with the exception of A.
baumannii and P. aeruginosa, who are unaffected by her magic. She can endure battle even longer
than Imipenem, however, and is a better fighter against Strep pyogenes.
Like Imipenem, she travels by Somas waterways to answer the call to fight, and even though she is
gentle to her surroundings, her presence has been known to awaken the feared C. difficile, or upset
the balance in the Marshes of Alimentum, thus she is usually called in only as a last line of defense
when others have failed.
94
Apothecary Healers| Carbapenem
95
Erythromycin
Nom de Guerre: Erythro
Age: Elderly
Clan: Saccharopolyspora erythraea
Family: Macrolide
Association: None
Specialties: B. henselae, B. pertussis, C. jejuni
Will not fight alongside Clindamycin.

Spawned by the Lords themselves, Erythromycin was one of the first Pestilence agents
ever to cross over to the side of the Apothecaries, and she quickly proved to be a
valuable asset. She is particularly effective against the more obscure Lords, and can
serve as a capable backup when Penicillin cannot be called to battle.
But Erythromycin has a dominant personality, and is not gentle or tactful. Her presence
can be polarizing, causing agitation when she interferes with communication among
Somas inhabitants. She can at times inflict significant damage and trigger panic,
stirring up fear and irrationality. Meanwhile, other residents fall under her spell,
devoted and fanatical, with some even dying of heartbreak when she departs. She can
also obstruct the efforts of fellow Apothecaries, inhibiting Somas support forces and
forcing some warriors to retreat in search of more resources before the battle is ended,
as well as causing others to linger longer than is wise.
There are additional weaknesses. The acidic waters around the Southern Dam
neutralize her powers. She takes care, too, to avoid her cousin, Clindamycin, with
whom she has such clash of personalities that both impede the others ability to fight.
Yet despite her shortcomings, Erythromycin can devastate a good many Lords, as her
troops rapidly disperse throughout the land and restrain the Lords abilities to generate
the basic structures they need to survive. Her distinctive reddish armor and aura is a
welcome sight when the battle is fierce.
96
Apothecary Healers| Macrolide
Nom de Guerre: Gent
Gentamicin
Age: Elderly
Clan: None
Family: Aminoglycoside
Association: None
Allies: Beta-Lactams, Carbapenems
Specialties: S. aureus, S. epidermidis
Can not be harmed by Lacta Mace
Intelligence sabotage,
block, crushing grip
Heat resistance
Gentamicin is a grizzled veteran of the Apothecary Army. Like many of his fellow
Apothecaries, he strikes down Pestilence armies by inhibiting the beasts abilities
to produce the very building blocks of life. He can also interfere with enemy
communication, resulting in garbled battle plans and blueprints. He is impervious to
extreme heat, and is effective against a wide range of Lords, mostly those of the Unstained
Legion. However, Gentamicin is not the gentlest of Somas defenders, and his presence
can have devastating effects on the land.
Just as he inhibits the ability of Pestilence agents to generate critical compounds of
life, Gentamicin can also have the same effect on the workers of Somas main filtration
centers. Killing these vital contributors to Somas overall well-being in turn leads to the
failure of the filtration systems and the release of toxins throughout the land.
Furthermore, Gentamicins drunken master technique is known to disturb the
harmony of a key communication post, Auditoria, cutting off contact between Soma and
surrounding islandsnot to mention Apothecary strategists. Gentamicins carelessness
can bring disequilibrium to the nearby Vestibular Labyrinths, where the buoyancy of the
floating island is regulated. Damage to this region can result in Somas overall instability,
throwing the island and all of its inhabitants off balance.
Balance can be restored after Gentamicin departs, but some damage, including that to
Auditoria, is permanent. As a result, Apothecary strategists have often been reluctant
to send Gentamicin into battle, though some worry that the alternativemore broadspectrum Apothecarieshas led to the rising resistance problems now faced by Soma.
98
Apothecary Healers | Aminoglycoside
Levofloxacin
Imipenem/Cilastatin
Nom de Guerre: Imipenem
Age: Mature
Clan: None
Family: Carbapenem
Allies: TMP-SMX, Aminoglycosides
Specialties: A. baumannii, P. aeruginosa, K. pneumoniae
Weakness: Defenseless against a Carbapenem Mace.
Spells, prevent skin growth

Imipenem and Cilastatin are a commanding, elite duo.
The powerful sorcerer Imipenem destroys a variety
of Pestilence agents, while his guardian, Cilastatin,
protects him as he works his magic. Imipenem thwarts
the Lords abilities to multiply by preventing them
from growing skin. Without his guardian Cilastatin,
however, Somas filtration system would quickly arrest
Imipenems powers and inhibit his spells. But together,
the pair can defend Soma against attacks in Respiro
Forest, the Boundary Wall, the Caverns of Bladdara, and
other vulnerable cities.
When called to action, the duo appear in Somas main
waterways, or in the countryside where they
follow the streams and rivers to the
battlefield. Imipenem is related to
the great Penam clan, but where
Nom de Guerre: Levo

Age: Young
Clan: None
Family: Fluoroquinolone
Association: None
Allies: Doxy, Cephalosporins
Specialties: B. anthracis, L. pneumophila, P. mirabilis,
Staph saprophyticus, Shigella, S. typhi
Quick penetration
the Penicillins cause

harm to the land, this
duo proceeds with greater
care. Yet on rare occasions,
Imipenems magic results in
destructive earthquakes, or disturbs the
normal flow of the Marshes of Alimentum,
harming inhabitants and Respiro Forest.
Because of this rare but deadly risk, the
duo are typically called in only as a lastditch effort, when other measures
have failed.
100
Apothecary Healers | Carbapenem
Apothecary Healers | Fluoroquinolone
Levofloxacin is a crafty Apothecary, with the power

to slay Pestilence armies infesting the Respiro Forest,
the Marshes of Alimentum, and the areas surrounding
the Caverns of Bladdara. He can also be deployed
alongside other Apothecaries to defeat the most
serious infestations. Levofloxacin is known for his
ability to quickly reach the site of battle. He can enter
Soma through either the river system or Buccal Bay
and, from either place, locate the enemy far faster
than most of his brethren.
Generally a gentle warrior, on rare occasions he loses
his temper, inadvertently destroying paths through
the Skeletal Mountains or slicing power lines in the
valleys, disrupting activity throughout the region.
Though chances of such destruction are low, the
consequences are severe, making this hero a subject
of much controversy and discussion.
This sly warrior attacks a critical part of the
Pestilence chain of command, preventing the
reproduction and growth of their armies.
While it is a swift and effective assault,
strategists fear they have taken
advantage of his skill too frequently
for too longand the rise of
Pestilence agents who can
repel Levofloxacin in battle
is the result.
101
Linezolid
Nom de Guerre: Linezolid
Age: Very young
Clan: None
Family: Oxazolidinone
Association: None
Fighting Style: Containment, occasional deadly force, last
resort
Allies: Aztreonam, third-generation Cephalosporins,
Clarithromycin
Specialty: VRE, MRSA, VRSA
Only effective against Stained Legion.
Psionic stun, preemptive

strike, crushing grip
Linezolid is an arrogant and wealthy combat specialist with unparalleled psionic
powersand unparalleled retainer fees. Unrelated to other Apothecary warriors,
she comes from alien origins and is new to the Apothecary ranks. Furthermore, in
her relentless, obsessive approach to defeating enemies, she takes few precautions,
caring not if she harms the innocent along the way. She is one of the most dangerous
Apothecary warriors.
Her psionic attack can erase the thoughts of invading Lords, leaving them stunned and
simple-minded, unable to manufacture any of their dastardly tools, spells, weapons, or
poisons. Although many Apothecary warriors use tactics to inhibit or impede, Linezolid
is the lone warrior who can stop the Lords at an early stage in their plans, before they
even begin. But her powers only work well against the Stained Legion, who are marked
by their purple stain, a distinctive aura that surrounds their being and leaves a trace that
Linezolid is able to sense.
When Linezolid joins the battle, especially if she lingers too long or ends up engaged
with the Unstained Legion, there can be dire consequences for innocent bystanders, who
can become blinded or shell-shocked. And something about her unusual powers can
cause the underground streams of the Skeletal Mountains to stop running, stressing and
fracturing the very structure of Somas core, threatening its existence.
It is easy to see why Linezolid is not called to battle except in times of extreme
desperation. But when faced with rampaging VRE or MRSA, she is one of the only heroes
who can save Soma.
102
Apothecary Healers | Oxazolidinone
Metronidazole
Nom de Guerre: Metro
Age: Elderly
Clan: None
Family: Nitroimidazole
Association: None
Allies: Aztreonam, third-generation Cephalosporins, Clarithromycin
Specialty: B. fragilis, C. difficile
Dislikes alcohol.
Toxic injection, potioncraft,

low-oxygen tolerance
Though Metronidazole is best known for her swift action against the increasingly
common attacks of C. difficile, she is also widely effective against other menaces,
particularly those that live without oxygen. She can be called into action for
attacks on the Boundary Wall, the Skeletal Mountains, Respiro Forest, the Marshes
of Alimentum, and other regions. She kills her opponents from the inside out,
generating a potent substance that susceptible Pestilence agents absorb into their
bodies. There, the potion is converted into toxins that deactivate more than 100
different enzymes necessary for the organisms survival. The toxins also affect the
Lords DNA, disrupting their genomic stability.
Her counterattacks do take their toll, however. She can disrupt the flow of the
marshes, irritate the Occulos, generally disrupt Somas balance and structure, and
cause great unrest among the populace. Her visits are also suspected to cause more
serious ailments after she has departed, with disgusting growing blobs that sicken the
land having been found in her wake. She has even been known to affect Sententia,
destroying key control centers in the city, and causing cascading system failures that
can threaten the whole of Soma. These dangerous afflictions mostly occur when
Metronidazole remains for too long within Soma, or during nationwide celebrations
that include consumption of alcoholic tinctures.
104
Apothecary Healers | Nitroimidazole
Oxacillin
Nom de Guerre: Oxacillin
Age: Young
Clan: Penam
Family: Penicillin
Specialties: S. aureus, S. epidermidis
Can not be harmed by Lacta Mace
Gore
Before the Apothecary Healers arrived in Soma, Staph aureus dragons were a deadly and
widespread menace. That started to change when Penicillin ordered his pet bull, Meticillin (also
known as Methicillin), to stand guard over Soma. This led to retaliation from S. aureus stronger
cousins MRSA, who laughed at Meticillins attempts to scare them off - in fact, when MRSA were
first encountered, they were named Meticillin-resistant S. aureus for this reason.
Oxacillin, direct descendant of Meticillin, has been carrying on the job of scaring away S.
aureus since Meticillin died. One strike from Oxacillins massive horns weakens the armor of
Staphylococcus agents, exposing the Lords fragile insides and causing them to literally fall apart.
Most importantly, Oxacillins thick hide protects it from the Lacta-Mace, a weapon specifically
honed to take down most other Beta-Lactam Apothecaries, thus it is Oxacillin that is called in
to fight against S. aureus instead of others in the Penam clan, because of this advantage. But like
Meticillin, Oxacillin is no match for MRSA.
106
Apothecary Healers | Penicillin
107
Penicillin
Nom de Guerre: Pen

Age: Ancient
Clan: Penam
Family: Penicillin
Allies: Cipro
Specialties: C. perfringens, N. meningitidis, P. multocida,
S. pyogenes, S. pneumoniae, T. pallidum
Note: Served in World War II.
Destroy armor
Penicillin is the founding father of the Apothecary Army. Before he
began to battle the Lords of Pestilence, Somas only line of defense was
the Nodal Sentry, which often failed against the likes of Staphylococcus
and Streptococcus creatures. Penicillin, a Beta-Lactam warrior, became
the first Apothecary to join the battle against Pestilence invasions, and
continues to be a valuable soldier to this day, in addition to spawning
many of the younger Apothecaries. Needless to say, the Apothecary
Army would not be what it is today without Penicillin, and Soma would
not be the thriving ecosystem it has become.
Penicillin was born on a fungal-dominated island, where he sprang
to life amid a terrible drought. He was recruited to help defend
Soma by one of the original Apothecary scouts, Alexander Fleming,
who immediately recognized his fighting potential. Like all BetaLactam Apothecaries, Penicillin kills susceptible Pestilence agents by
destabilizing their armor, preventing the proper plate linkages that
normally protect the Lords from destruction. Without intact armor, the
Pestilence armies literally fall apart. Penicillin is particularly effective
at penetrating to the deeper layers of Pestilence armor, rendering the
creatures weak and vulnerable.
Like many other Apothecaries, Penicillins battles can take a toll on the
land, often disrupting the flow through the Marshes of Alimentum and
occasionally affecting the critical activity within Sententia. But such ailments
are often a small price to pay for the elimination of the Lords that threaten
Soma, and Penicillin remains a respected leader of the Apothecary Army.
108
Apothecary Healers | Penicillin
Piperacillin/Tazobactam
Nom de Guerre: Pip Tazo
Age: Young
Clan: Penam
Family: Ureidopenicillin
Association: Beta-Lactam, Anti-Lacta Mace,
Anti-Pseudomonal
Specialty: P. aeruginosa
Anti-Lacta Mace armor

Piperacillin and Tazobactam are a powerful duo, effective against all but the
most resistant Pestilence armies, such as MRSA and VRE. While Piperacillin
on her own is an effective killer of a wide range of Pestilence species, she
is susceptible to some of their poisons, and cannot normally withstand the
dreaded blow of the Lacta Mace. Tazobactam neutralizes those poisons, and
his thick armor easily deflects Lacta Mace strikes, allowing Piperacillin safe
passage to push forward and defeat even those Lords normally resistant to
Beta-Lactam Apothecaries.
These fighters join the battle by penetrating the Boundary Wall and making
their way directly to Somas river system. There they stay until their task
is accomplished, making sure that no Lords escape alive and begin to
accumulate secrets needed to defeat the Apothecary duo. A few battalions of
Pestilence armies have learned to resist the pair, howevermost notably C.
difficile. These Lords can survive Pip and Tazos attacks, causing severe unrest
in the Marshes of Alimentum and threatening dehydration throughout the land.
Furthermore, the duo have been known to inflict their own harm around Soma.
When they blast through the Boundary Wall in search of waterways, they can
cause pain and unrest in the surrounding towns. And, once fully engaged in
battle, they can disrupt the flow of the Marshes of Alimentum or even cause
miscommunication and confusion among the workers of Sententia. Thus, these
soldiers are often reserved only for invasions serious enough to warrant the risk.
Apothecary Healers | Ureidopenicillin
111
Streptomycin
Nom de Guerre: Streptomycin

Age: Ancient
Clan: Secondaries of Streptomyces griseus
Association: Anti-Tuberculosis Agents
Allies: Vancomycin, Penicillin, Tetracyclines
Specialties: Y. pestis, fireblight
Intelligence sabotage,
block, bind
Streptomycin is the revered matriarch of the Apothecary Healers, one of the first ancients to begin fighting back
against the Lords of Pestilence, back when Penicillin and the ancestors of Sulfamethoxazole were the only other
defenders of Soma. Although she grew up among the Lords, and the blood of the Stained Legion still runs in her
veins, she was the first to follow her conscience and defect from the Pestilence ranks, changing sides and setting
an example that others followed.
Streptomycin was brought into existence by Streptomyces griseus, a soil-dwelling Lord of Pestilence with godlike
powers of creation. Unlike other Lords hellbent on destruction, S. griseus was a creator and a bringer of gifts. She
combined the elements around her to create 32 different individuals, known as the Secondaries, and scattered
them across the world to defend the meek.
The legend of Streptomycin begins with a young man named Schatz, who witnessed her fighting against M.
tuberculosis one day and invited her to come to Soma where M. tuberculosis were running rampant and causing
millions of deaths. Schatzs boss was a clever and unscrupulous Wax Man who locked Schatz in a basement and
paraded Streptomycin for all the world to see, coining the name Apothecary Healers and gaining fame and
fortune in the process.
Streptomycin, however, was above these petty politics, and quickly got to work defending Soma, striking down
Pestilence armies by inhibiting their ability to produce the very building blocks of life, and sabotaging their
communication lines. She was the first to defeat M. tuberculosis and was constantly fighting on the front lines in
days of old, but since then many of her old foes have found ways to resist her in battle.
Today Streptomycin is an aging Healer and only used in battle for rare invasions by Y. pestis, or
F. tularensis. She also still fights against A.R.E. alongside Vancomycin. Since she has a reputation for sometimes
damaging Auditoria and the Vestibular Labyrinths in her zeal, she is usually not the first to receive the call for
help, reserved instead for emergencies when other Aminoglycosides or Anti-Tuberculosis fighters are failing.
She spends most of her time these days on farms and orchards, defending the cattle, horses, and sheep from
Pestilence attacks, protecting crops, and preventing fireblight on apple and pear trees.
112
113
Tetracycline
Nom de Guerre: Tetracycline

Age: Ancient
Clan: None
Family: Tetracycline
Association: None
Ring weapons, block, crushing grip
Tetracycline is one of the Apothecary Armys great heroines, having saved Soma
on many occasions from Vibrio cholerae, during an age when that particular
Agent of Pestilence was one of the biggest threats. With her four circular, toxinsheathed blades, she slices through Somas enemies and prevents them from
producing the essential building blocks of life. When she first joined the army,
she could wipe out nearly all threatening Pestilence armies. But over time,
many Pestilence agents have learned to shield themselves from Tetracyclines
attacks: when they cinch and reinforce their armor, her blades skip harmlessly
off their backs.
She is still effective against many agents of both the Stained and Unstained
Legions, however, and is most often called into action to oppose threats like
Chlamydia, Mycoplasma, and Rickettsia, and is occasionally enlisted to do
battle with other Lords, including the dreaded Bacillus anthracis.
Notably, her strategy is a safe one for Soma, the inhabitants of which are
naturally resistant to her poison. Because she is so gentle, she is a common
patroller of the islands Boundary Wall, fighting off pesky Pestilence agents
that never make it beyond the wall, but cause unrest and infect nonetheless.
Tetracycline also performs scouting missions for Apothecary strategists, due
to her ability to quickly make her way to the Skeletal Mountains and return
intelligence on their ongoing expansion, which can yield insight regarding
disease threats on Soma.
114
Apothecary Healers | Tetracycline
Ticarcillin/Clavulanate
Nom de Guerre: Tic Clav
Tigecycline
Anti-Lacta Mace armor
Age: Mature
Nom de Guerre: Tigecycline
Clan: Penam
Age: Very young
Ticarcillin is a descendent of the heralded

Penicillin, and is almost always found in battle
alongside the great Beta-Lactam protector,
Family: Carboxypenicillin
Clavulanate. Ticarcillin prevents the proper linking
Association: Beta-Lactam, Anti-Lacta Mace,
of the Lords armor, causing them literally to fall
Anti-Pseudomonal
apart as they attempt to reproduce. Clavulanate,
meanwhile, protects Ticarcillin from the Lacta
Mace and from toxins released by many Lords.
Together, the duo is effective against a wide range of Pestilence armies, primarily those of the Unstained
Legion who invade the Respiro Forest, including the dreaded Pseudomonas. They are often compared to
their cousins, Piperacillin and Tazobactam, and Apothecary strategists are often torn as to which pair to
dispatch into battle in Somas time of need, as they have similar battle records against the enemy.
Clan: None
Family: Glycylcycline
Association: None
Ticarcillin and Clavulanate enter Soma directly into the streams and rivers or through the countryside, as
they are unsuccessful at reaching the site of battle via Buccal Bay. Nevertheless, they
are known to disrupt the flow through the Marshes of Alimentum, just like many
of their Apothecary brethren. They can also cause pain and disruption
to Sententia and may cause unrest in the
communities surrounding the place where
they entered into Soma.
116
Apothecary Healers | Carboxypenicillin
Tigecycline is a younger Apothecary warrior,

giving her the advantage of unfamiliarity, as many
menaces are surprised to meet her in battle. Like
many of her fellow Apothecaries, she strikes by
inhibiting the ability of Somas enemies to produce
key proteins and metabolites that drive their attacks.
Depending on the enemy at hand, her attacks can
be as effective as some of the great Apothecary
legends, and she is one of the few warriors who can
take down the dreaded VRE. She also is effective
against a wide range of other Lords, including
several who have evolved to evade the attacks of
her predecessors. Strangely, however, she has not
proven herself against the Pseudomonas Lords.
She works her way up the waterways of
Soma to the site of battle, usually along
the Boundary Wall or near the Marshes
of Alimentum. Though relatively gentle
compared to some warriors, her presence has
been known to accelerate the current into Fecal
Inlet, reverse the flow of Buccal Bay, and even
disrupt the pace of life in Twin Heart City.
Apothecary Healers | Glycylcycline
117
Tobramycin
Nom de Guerre: Toby

Age: Mature
Clan: None
Association: None
Allies: Carbapenems, Cephalosporins
Specialties: B. henselae, B. pertussis, C. jejuni
Has a deafening battle cry.
Intelligence sabotage, block, crushing grip

Tobramycin is a ruthless warrior, despite his affectionate nickname Toby. His spy maneuvers
sabotage the Lords most vital communications, the translation of their secret codes. When he
garbles their messages, the Pestilence armies cannot organize, follow orders, or even maintain
their basic functionsand they eventually die. Like others of the Aminoglycoside family, Tobys
sugar-based armor cannot withstand the acidic conditions of many of the lands waterways, thus
he travels to afflicted areas by air or using special vessels.
Once inside, he has an unrivaled talent for infiltrating groups of
collaborators and getting behind enemy lines to save the most threatened
inhabitants. He can strike quickly and efficiently, minimizing further
damage that would be inflicted by the Lords. And he is particularly
lethal against the dreaded Pseudomonas, a fearsome foe who feasts on
the weak and injured.
Toby is an undeniable force of the Apothecary Armybut his
unchecked power can often have dire consequences
for Soma itself. If full-on battle rages in one area
for too long, the explosions he causes and his
piercing battle cries can deafen locals and leave
them dizzy and disoriented. His battles can even
cause dysfunction of the lands vital filtration
system. As a result, Toby must be unleashed with
caution, and monitored carefully as he works his
devastating magic.
118
Trimethoprim/
sulfamethoxazole
Nom de Guerre: Co-trimoxazole, TMP-SMX
Age: Elderly
Clan: None
Family: Sulfonamide
Association: None
Allies: Imipenem
Specialty: N. Asteroides, P. mirabilis, Staph saprophyticus
Can leave behind sharp crystals.
Starve
The crystalline synthetic warriors Trimethoprim and Sulfamethoxazole
have a sordid history. Trimethoprim is a mighty sorceress who has
learned how to stop the Lords ability to produce a nutrient so essential to
their existence that she can starve them and kill them from the inside out.
She is one of the few who can defeat Nocardia asteroides, and has fought
well against Klebsiella pneumoniae for many years.
Almost half a century ago, Apothecary strategists allied her with
Sulfamethoxazole, a massive warrior who charges ahead of Trimethoprim. He
targets the Lords supply chain of another critical element they need for survival,
reducing the burden on Trimethoprim.
The two warriors fought together for more than a decade, before Apothecary
strategists decided that the partnership was no more effective than Trimethoprim
on her own. Furthermore, Sulfamethoxazole is not the gentlest protector of Soma.
He irritates the outflow from the filtration system and the Caverns of Bladdara, and
generally affects the flow of the islands rivers and streams. He is also a prankster, tricking
the Nodal Sentry into fighting battles against imaginary opponents, and poisoning the
food served in the galleys of the Nodal Sentry barracks. As a result, the Apothecary
strategists dissolved the relationship nearly 20 years ago, allowing Trimethoprim to
battle alone once again.
But now, as the Lords of Pestilence evolve to evade numerous styles of
Apothecary attacks, strategists are reconsidering the pairing. Together, the two
warriors have the ability to take down the dreaded MRSA legions, and for that
reason alone they are quickly becoming known yet again as one of the greatest
Apothecary duos.
Apothecary Healers | Sulfonamides
121
Vancomycin
Nom de Guerre: Vanc, Vanco
Age: Elderly
Clan: None
Family: Glycopeptide
Association: None
Specialty: S. epidermidis, MRSA,
Penicillin-resistant S. pneumoniae, C. difficile
He is only effective against the Stained Legion.
Starve
Vancomycin is a critical force in the Apothecary Army. He
was discovered by a recruiter more than 50 years ago in the
jungles of Soma. His name appropriately stems from the word
vanquish, due to his impressive talent for defeating enemies of
the Stained Legion, including MRSA and C. difficile.
Vancomycin can penetrate deep into the wilderness and fight
in areas that others cannot reach. His clever attacks disable the
production of a key component of Pestilence armor, a tactic
particularly vital against Lords who have learned to avoid the
blows of older Warriors like Penicillin. It is Vancomycins
unique qualities that motivated Apothecary leaders to usher
him into service just five years after his training began
record time for a new fighter.
He justified his fearsome reputation in his early days
of battle, successfully defeating even the most resilient
Lordsbut at that time he had not yet learned to focus his
wrath on his foes alone, leaving Somas earth damaged
from his imprecise assaults. But over time, he has been
stripped down to his pure, Pestilence-fighting essence,
and now rarely leaves his mark on the land itself. Recently,
however, some Lords have finally been able to sidestep his
attacks, instilling fear in those who seek peace in Soma. If
Vancomycin cannot defeat these dreaded foes, who can?
Apothecary Healers | Glycopeptide
123
Healing Blade Interactions
124
125
Real-world Interactions
126
The preceding interactions table comes from the physical card game version of Healing Blade. The data for that table was simplified to
improve gameplay. In real life, the interactions are much more complex. This table comes closer to capturing the real-life interactions
between antibiotics and bacteria in current clinical practice, as of 2014. Needless to say, this table is a reference for entertainment only.
It does not replace professional medical judgment for treatment of any condition.
127
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What is the Healing Blade?

What is the Healing Blade?

What is the purpose of the Bacterionomicon?

What is the purpose of the Bacterionomicon?

Bl

Arun Mathews M.D.

Juan Diego Dianderas

Stephen Shek of QP Group

The enemy of art is the absence of limitations.

he Bacterionomicon was originally written to be a simple

we developed in 2009, the Healing Blade. it grew into so much

Origin Story: Cognitive Rehearsal

One morning after an evening of involved video-gaming some years back, I

Realism vs. The Abstract

A Methodology for Art Creation

Fundamentals in place, and an overarching directive to focus on things that

The Bacterionomicon: An Exercise in World-Building

There was a time that Ampicillin, with her predictable attack

In the following description of the antibiotic Azithromycin, note how the

e sincerely hope that you enjoy the exercise in

metaphor that is the Bacterionomicon. Indeed, what

Azithromycin, son of the great Erythromycin, is one of the most commonly

appreciate any feedback, thoughts and suggestions. In

Healing Blade Interactions

Sicken forest, contaminate waterway,

Gelatinous pelt, adaptive defenses,

Affinities: Infirmaries, Battlefields

Scholars who study these monsters have

A. baumannii is very slow, oozing through the landscape

Burn, bite, venom, suffocate,

A. baumannii is notorious for adapting to Soman

B. anthracis is armed with a lethal trio of

Lords of Pestilence | Stained Legion Rod

Spread a sickness called Fried Rice

B. cereus are hardy reproducers, laying spores that can

These creatures claw their way down the banks of the

Lords of Pestilence | Stained Legion Rod

Bite, flay skin, poison, plant bombs,

The presence of B. cereus, a relatively

Alias: Break-Apart Scavenger

Lords of Pestilence | Unstained Legion Rod

Bite, venom, manipulate fluids,

This massive feline creature, which resembles an

Aliases: Pertussis, Haemophilus pertussis

Sicken forest, poison, suffocate, create

B. pertussis has additional chemical

Lords of Pestilence | Unstained Legion Rod

Lords of Pestilence | Unstained Legion Coccobacillary

This cunning witchs name means twisted, in

Aliases: Jejuni the Twisted, Guillain-Barr

Charming gaze, poison water/food,

Weaponized back-plates, bite, sabotage,

Lords of Pestilence | Unstained Legion Spiral | Bulls Eye

Lords of Pestilence | Unstained Legion Spiral

Aliases: Seediff, Toxic Megacolon

Lords of Pestilence | Stained Legion Rod

Toxic gas, manipulate

Lords of Pestilence | Stained Legion Rod

Lords of Pestilence | Stained Legion Rod

Strangle, suffocate, burn, manipulate