Italy have been hit with another back-row withdrawal as Seb Negri will miss Sunday's Six Nations clash with Ireland due to a fever.
Talisman captain Sergio Parisse was ruled out of Sunday's Rome encounter at the top of the week, due to a head injury.
The Azzurri were already feeling the loss of their stalwart number eight, but now head coach Conor O'Shea has revealed the physical flanker Negri was only pulled from the line-up on Thursday morning.
Former Ireland full-back O'Shea remains convinced of Italy's back-row strength however, calling on his side to heap pressure on Joe Schmidt's visitors at the breakdown.
"We have chosen players who can be 100 per cent physically ready, which is why Seb Negri is not in the line-up: this morning he had a high fever and we need our players to be physically ready," said O'Shea.
"We have worked hard on the breakdown, we think it is one of the areas where we can put pressure on Ireland."
Benetton flanker Negri's absence is also compounded by a long-term injury to Gloucester's bullish back-rower Jake Polledri.
Zebre duo Maxime Mbanda and Jimmy Tuivaiti will start in a rejigged back row, with ex-Harlequins boss O'Shea confident in his selection.
Toulouse hooker Leonardo Ghiraldini will captain the side in Parisse's absence, with ex-Leinster fly-half Ian McKinley taking a seat on the bench.
O'Shea is yet to lead Italy to a Six Nations victory, with his time at the Azzurri helm now stretching into a third championship.
The 48-year-old's brief is as much to build Italian rugby's infrastructures as steer the Test team, but he admitted the time for victories is at hand.
"Last week in Viadana, Mbanda and Tuivaiti played well with Zebre, there is great depth in that area," said O'Shea.
"If we can work on the things we can control we can be very competitive against Ireland.
"The intensity must always be high: we are on the right track I'm sure, but the results must start to arrive too."
— Italrugby (@Federugby) February 22, 2019
Italy team to play Ireland
Forwards: 1 Andrea Lovotti (Zebre Rugby Club), 2 Leonardo Ghiraldini (CAPTAIN, Stade Toulousian), 3 Simone Ferrari (Benetton Rugby), 4 Federico Ruzza (Benetton Rugby), 5 Dean Budd (Benetton Rugby), 6 Jimmy Tuivaiti (Zebre Rugby Club), 7 Maxime Mbanda (Zebre Rugby Club), 8 Abraham Jurgens Steyn (Benetton Rugby)
Backs: 9 Tito Tebaldi (Benetton Rugby), 10 Tommaso Allan (Benetton Rugby), 11 Angelo Esposito (Benetton Rugby), 12 Luca Morisi (Benetton Rugby), 13 Michele Campagnaro (Wasps), 14 Edoardo Padovani (Zebre Rugby Club), 15 Jayden Hayward (Benetton Rugby)
Replacements: 16 Luca Bigi (Benetton Rugby), 17 Cherif Traore (Benetton Rugby), 18 Tiziano Pasquali (Benetton Rugby), 19 David Sisi (Zebre Rugby Club), 20 Alessandro Zanni (Benetton Rugby), 21 Guglielmo Palazzani (Zebre Rugby Club), 22 Ian Mckinley (Benetton Rugby), 23 Tommaso Castello (Zebre Rugby Club)