Activate Shilgengar by sacrificing Scuzzback Marauders.
When Scuzzback Marauders dies, its persist ability triggers, returning it from your graveyard to the battlefield with a -1/-1 counter on it.
Resolve the Shilgengar ability.
Activate Shilgengar by sacrificing Scuzzback Marauders.
When Scuzzback Marauders dies, its undying ability triggers, returning it from your graveyard to the battlefield with a +1/+1 counter on it.
Resolve the Shilgengar ability.
Repeat.
This grim loop relies on the fascinating interaction between Scuzzback Marauders's native persist and the undying ability granted to it by Mikaeus, the Unhallowed. Because Shilgengar, Sire of Famine lets you sacrifice creatures to generate Blood tokens, you can feed the Marauders to the Sire repeatedly; each time the Marauders dies, alternating between a -1/-1 counter and a +1/+1 counter allows its death triggers to reset its counters indefinitely. As the Scuzzback Marauders continually enters and leaves the graveyard, Shilgengar, Sire of Famine's sacrifice outlet steadily buries your opponents under an endless tide of Blood tokens.