Nine-man USA held 10-man Italy to a 1-1 World Cup draw to keep their hopes of qualifying for the second round alive.

Marcello Lippi's side took the lead after 22 minutes when Alberto Gilardino escaped the attentions of his marker to flick a diving header from Andrea Pirlo's free-kick beyond Kasey Keller.

But the Azzurri's joy lasted four minutes as defender Cristian Zaccardo's poor defensive clearance from Bobby Convey's cross found his own net.

Daniele De Rossi was sent off shortly before half-time for a clear elbow on Brian McBride and the USA's Pablo Mastroeni soon joined him after a harsh challenge on Pirlo.

Amazingly, the USA were then reduced to nine men two minutes into the restart when Eddie Pope collected his second caution of the evening, but they had a lucky escape 10 minutes later when Carlos Bocanegra headed an inswinging free-kick against his own crossbar with Keller beaten.

The nine men of the USA then thought they had taken the lead when DaMarcus Beasley smashed a left-footed effort past Gianluigi Buffon - only for the active Brian McBride to be deemed offside.

As play switched down the other end, Keller pulled off a fine save to push out Alessandro Del Piero's volley and that was as near as the Azzurri came as Bruce Arena's men held out.

The result means there will be all to play for when Group E is concluded on Thursday with all four teams still in with a chance of progression to the second round.