Grigor Dimitrov came out strong but faded fast as the Winston-Salem Open's top seed was forced to retire from his match against Dominic Thiem, sending the Austrian into the round of 16.
With less than a week to go before the start of the US Open, Dimitrov came out sharp, unleashing a torrent of backhanded slices to keep Thiem off balance as the Bulgarian raced through the surprisingly one-sided first set 6-0.
But things took a turn for the worse for Dimitrov at 2-2 in the second and he began to misfire in bunches in an apparent attempt to shorten points.
After a visit from medical staff, he stepped up to the line to serve while trailing 2-4 but decided he was feeling too unwell to continue and shook hands at the net, where he waited for Thiem while hunched over.
The win gives another lifeline to 2020 US Open champion Thiem, who had to save two match points to win his rain-delayed opener against American J.J. Wolf the day before.
Thiem will next face either Italy's Fabio Fognini or Britain's Jack Draper.
Earlier in the day, France's Benjamin Bonzi, Australia's Jason Kubler and Americans Maxime Cressy and Steve Johnson were among those who advanced in straight sets at the ATP 250 tournament in North Carolina.
Abhishek Sharma's 19-ball fifty went in vain as world champions India were surprisingly beaten by Ireland for the first time in international cricket, slumping to a 34-run defeat in the first Twenty20 in Belfast on Friday.
England roared back into contention on the second day of the third and deciding test against New Zealand with Ben Duckett's rapid century helping his side to 223-2 after three wickets for returning captain Ben Stokes helped to dismiss the visitors for 438 at a sizzling Trent Bridge.
American great Serena Williams will face Australian 20-year-old Maya Joint in the first round of her eagerly awaited return to Wimbledon, a potentially tricky tie for the seven-time champion playing at the tournament for the first time since 2022.
Australia booked their spot in the knockout rounds of the World Cup on Thursday after a cagey draw against Paraguay, who are set to qualify as a third-placed finisher, while Turkey beat USA 3-2, scoring the winner with virtually the last kick of the match.