Italy v Paraguay - Match highlights
Italy goalkeeper Gianluigi Buffon has missed training for the second successive day amid fears that he may not play again in the 2010 World Cup.
The 32-year-old sat out Wednesday's session and tests on his injured back show a small herniated disc as well as a sciatic problem.
Italy team doctor Enrico Castellacci said the recovery would "not be brief".
Buffon was replaced by substitute Federico Marchetti at half-time in Monday's 1-1 draw against Paraguay.
Buffon initially said he hoped "to recover in two days" but the Azzurri may now have to defend their status as world champions without their experienced keeper.
Buffon's Italy and Juventus team-mate Giorgio Chiellini admitted losing the world's most expensive keeper would be a huge blow.
"A good goalkeeper is just as valuable as a striker who scores a lot of goals," stated Chiellini.
"It's obvious how much he's worth to the team."
Buffon could do little to stop Paraguay taking the lead on a rain-drenched night in Cape Town, with Antolin Alcaraz making the most of some hesitant defending from captain Fabio Cannavaro and Daniele De Rossi to head home the opener.
But De Rossi made amends after the break when some dreadful goalkeeping from Paraguay's Justo Villar allowed the midfielder to nip in and equalise from a corner.
"During the warm-up Buffon felt a pain in his back and after the first half he couldn't continue," commented Italy coach Marcelo Lippi.
"It was a big blow. We lost a substitution that we could have used.
Buffon is regarded as the one of the best goalkeepers in world football
Italy struggled to get going in what was their first World Cup match since winning the tournament in Germany in 2006.
The awful weather did not help their cause though, and Lippi, who masterminded the triumph in Berlin four years ago, insisted his team had made a satisfactory start to their title defence.
"Italy is right here. We're here tactically, physically, with our hearts, we're here full stop," Lippi added.
"I just regret that we did not get the points we deserved, but sometimes that's what happens, you get less than you deserve.
"The important thing is this was not a decisive game. What is important is that people now realise we are here and have got our act together."
"We deserved to win," De Rossi reflected. "We controlled the ball virtually the entire time, but it's not easy against these teams that dream simply of drawing with the world champions.
"And if you fall behind, it becomes even tougher."
De Rossi equalises for Italy
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