Australia U20s coach Nathan Grey has been forced into several changes to his squad as he named his side to face Italy on Friday (AEST).
It comes off the back of a physical 35-11 win against Georgia, losing Jack Barrett, Tevita Alatini and Ben Di Staso for the rest of the tournament to injuries.
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On top of this, scrum-half Hwi Sharples missed the opening game with a hamstring injury and will not feature in the tournament.
Waratahs quartet Nathaniel Tiitii, Billy Dickens, Will Goddard and Austin Durbridge have joined the squad as injury replacements.
As a result, Grey has named a new-look front-row, with Lington Ieli, Ottavio Tuipulotu and Trevor King named to start.
Ollie McCrea starts in the second row with captain Toby Macpherson, replacing Harvey Cordukes, who received a two-match suspension for his high tackle.
There is one change to the backline, with Angus Staniforth coming onto the wing.
Staniforth scored a double in the bonus point win over Georgia, joining standout Ronan Leahy and Shane Wilcox in the back-three.
Prop Tiitii and scrum half Dickens come straight onto the bench amid the injury crisis.
Tiitii featured in the Rugby Championship off the bench against Argentina whilst Dickens helped the Waratahs to the Super Rugby U19s Final.
Reds backrower Dominic Thygesen and centre Frankie Goldsbrough have been added to the bench as they look to continue their unbeaten start.
Goldsbrough was thrust straight into the Reds squad out of school and started in the centres in the win over South Africa in May.
Australia U20 vs. Italy U20
Athlone Sports Stadium, Cape Town
7pm Thursday 4 July (local) / 3am Friday 5 July (AEST)
1. Lington Ieli - ACT Brumbies, Tuggeranong Vikings
2. Ottavio Tuipulotu - Melbourne Rebels, Eastern Suburbs
3. Trevor King - Queensland Reds, Souths Brisbane
4. Toby Macpherson (c) - ACT Brumbies, Uni-Norths Owls
5. Ollie McCrea - NSW Waratahs, Eastern Suburbs
6. Aden Ekanayake - Australia Sevens, Gordon Rugby Club
7. Dane Sawers - Western Force, Kalamunda Districts
8. Jack Harley - ACT Brumbies, Gungahlin Eagles
9. Dan Nelson - ACT Brumbies, Canberra Royals
10. Harry McLaughlin-Phillips - Queensland Reds, Souths Brisbane
11. Angus Staniforth - ACT Brumbies, Canberra Royals
12. Jarrah McLeod - ACT Brumbies, Canberra Royals
13. Kadin Pritchard - ACT Brumbies, Gungahlin Eagles
14. Ronan Leahy - Western Force, Sydney University
15. Shane Wilcox - ACT Brumbies, Tuggeranong Vikings
Reserves
16. Bryn Edwards - NSW Waratahs, Sydney University
17. Nathaniel Tiitii - NSW Waratahs, Eastern Suburbs
18. Nick Bloomfield - Queensland Reds, Easts Brisbane
19. Eamon Doyle - NSW Waratahs, Sydney University
20. Dominic Thygesen - Queensland Reds, Souths Brisbane
21. Billy Dickens - NSW Waratahs, Eastern Suburbs
22. Joe Dillon - NSW Waratahs, Manly Marlins
23. Frankie Goldsbrough - Queensland Reds, Easts Brisbane