Italy coach Marcello Lippi is sweating on the fitness of Simone Perrotta ahead of Thursday's vital Group E game against Czech Republic.

The Roma midfielder was a passenger by the end of the Azzurri's 1-1 draw against the USA last weekend after taking a knock to his thigh which left him experiencing back pain.

Lippi did not withdraw Perrotta because he had already used all three substitutions and is now hoping the player did not exacerbate the problem by continuing.

Team doctor Enrico Castellacci said: "He suffered a heavy blow to his upper right leg. He may be able to recover but we will have to wait for further tests. We will only be able to confirm his availability on Wednesday."

Italy are short of options in midfield as Daniele De Rossi is suspended after his red card against the USA and Gennaro Gattuso is not yet 100 per cent fit following his groin strain.

Simone Barone and Mauro Camoranesi could be called in to Lippi's starting line-up for a game Italy must take a point from in order to progress to the last 16.