So it appears for the US, a win versus Italy on Saturday is all but necessary to have any chance of coming out of the tournament. A draw could potentially do it but with the 0-3 goal differential it doesn't appear likely.

Right now the standings are:
CZE 3, +3
ITA 3, +2
GHA 0, -2
USA 0, -3

Here's what I think will happen in Group E. It's a complete guess of course, but so is anyone else's prediction, and it could happen, you never know.

The US comes out to play against Italy and scores a hard-fought 2-0 victory on a spectacular shot from Claudio Reyna in the 84th minute, and a beautiful counter-attack run from Landon Donovan in stoppage time, while the Czechs cruise to victory against Ghana in a 4-0 rout. At the end of the second game, it will look like:

CZE 6, +7
ITA 3, --
USA 3, -1
GHA 0, -6

For the 3rd game in the series, CZE will know that barring a 7 goal swing, they have first place locked up, and not completely bring their A game, dropping the match to a desperate Italian side. Final score will 2-0. But the USA will come out energized from their last victory and firing on all cylinders against a Ghana side that's playing for pride and walk away victorious in a 4-1 shootout. Final standings will be:

CZE 6, +5
USA 6, +2
ITA 6, +2
GHA 0, -9

CZE will take the group on goal differential and the US will squeak out of the group in second place based on their head-to-head result with the Italians. CZE makes the finals but loses to Brasil, who will survive a squeaker with the US in the round of 16 with a 2-1 victory on a highlight reel goal from Ronaldihno.