Harlequins scrum-half Karl Dickson has been called into the England squad as a replacement for his younger brother Lee, who fractured a bone in his left hand against Scotland.
Lee Dickson, the Northampton scrum-half, is expected to be sidelined for four weeks after suffering the injury during his Test debut as a replacement in England's 13-6 Calcutta Cup victory.
Toby Flood is in contention for a return to the England team for Saturday's RBS Six Nations clash with Italy after being recalled to the training squad.
Flood made his comeback from a knee ligament injury, playing 30 minutes off the bench in Leicester's 24-13 LV= Cup win over Newcastle on Saturday.
The Tigers fly-half will have until Tuesday night, when England's 32-man squad is trimmed down, to convince interim head coach Stuart Lancaster of his match fitness.
England are monitoring the shoulder injury that forced Charlie Hodgson to leave the field against Scotland.
Manu Tuilagi (hamstring), Courtney Lawes (knee) and Tom Wood (toe) are all unavailable for the upcoming game in Rome's Olympic Stadium.
Tuilagi is expected to resume training with Leicester this week and is on course to be available for England's first home game of the Six Nations, against Wales on February 25.
England are growing short of available scrum-halves, with Richard Wigglesworth injured and Danny Care suspended following his arrest for drink-driving.
Karl Dickson, Care's understudy at Harlequins, has started only five games for his club this season and made only one appearance since the middle of November.
The 29-year-old joins joins Ben Youngs, who started at Murrayfield, and Wasps' Joe Simpson as England's scrum-half options for the Italy game.