Liverpool defender Martin Kelly has pulled out of the England Under-21 squad ahead of Tuesday's clash with Italy.
Kelly played the full match for Liverpool against Chelsea on Sunday in the Barclays Premier League but sustained a knock during the game.
The Football Association confirmed Kelly's withdrawal on Monday morning, ahead of the team's departure for the clash in Empoli.
England Under-21 coach Stuart Pearce has now lost six defenders for the trip, with Kieran Gibbs, Micah Richards, Chris Smalling, Kyle Walker and James Tomkins all out.
While Walker was promoted to the senior squad for Wednesday's international in Denmark, the other five have been lost to injury.
Sunderland midfielder Jordan Henderson, Bolton's on-loan striker Daniel Sturridge and Aston Villa midfielder Fabian Delph also previously withdrew from the group.
Leeds captain Jonny Howson was called into the squad for the first time as a replacement, and has been joined by Chelsea's Josh McEachran, Barnsley's Kieran Tripper, Leicester loanee Kyle Naughton and Crystal Palace forward James Vaughan.
Liverpool's head of sports medicine and sports science Dr Peter Brukner said Kelly was feeling the after-effects of a tough encounter at Stamford Bridge.
"Martin suffered a sprained ankle during yesterday's (Sunday's) game," Dr Brukner told liverpoolfc.tv.
"He was treated at half-time and able to continue but it was very sore after the game."