Tokyo - Tonga suffered a major Rugby World Cup setback on Tuesday as record points-scorer Kurt Morath was ruled out of the tournament and may need surgery after taking a boot to the throat.

The 34-year-old flyhalf, who plays in England for Championship outfit Doncaster Knights, injured his larynx when rampaging England centre Manu Tuilagi caught him during a tackle in their 35-3 Pool C defeat on Sunday.

"It was totally accidental," said assistant coach Pita Alatini, who revealed that Latiume Fositaa would be called up as a replacement.

"Kurt is still in hospital in Sapporo and may need surgery," said Alatini.

Centre Nafi Tuitavake also broke his arm towards the end of the bruising encounter in Sapporo, the coach said.

"It is obviously desperately disappointing for Kurt and Nafi - they have worked so hard to be here - but it means there are opportunities for others now."

Tonga's next game is on Saturday against Argentina, who will be desperate to bounce back from an agonising 23-21 opening loss to France.

Morath, Tonga's all-time record points-scorer with 349, has played in all every World Cup game for his country since 2011. He is by far his country's leading scorer at the competition with 73 points.

The New Zealand-born Morath scored 45 points for Tonga at the 2011 Rugby World Cup, putting him behind only South Africa's Morne Steyn and Australia's James O'Connor.

James Faiva, the likely candidate to replace Morath in the Tonga No 10 shirt, said it was disappointing to use their talisman but was also "a great opportunity to show my talents".

Faiva, also born in New Zealand, played for half-a-season at Spanish side El Salvador.