Novak Djokovic appeared to vomit during a changeover in the second set of his Cincinnati Open second-round match on 16 August, took a medical timeout, played on, and lost 2-6, 6-4, 6-4 to Argentina’s Thiago Agustín Tirante. Tirante, ranked No. 65 and cracking the top 50 for the first time in his career that same week, took his third top-10 win of the season after also beating Taylor Fritz in Montreal days earlier.

The loss broke a remarkable streak. Djokovic had gone 355-13, a 96.5 percent clip, after winning the first set at Masters 1000 level between 2005 and 2025. Tirante becomes only the 14th man to reverse a set-one deficit against Djokovic at that level, and only the second player ranked outside the top 30 to beat him in Cincinnati.

Djokovic did not name the condition, but he was clear it is not new.

“It’s just a condition that I have, health-wise, that has been bothering me for the past couple of years. A lot of issues, especially when it is humid and it is hot,” he said after the loss. He added that nerves “make it worse”.

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Mixed doubles loss and a short practice

The picture in New York did not improve. On Tuesday 25 August, Djokovic and world No. 1 Aryna Sabalenka went out in the first round of the US Open mixed doubles championship, beaten by top seeds Katerina Siniakova and Henry Patten on Arthur Ashe Stadium. The pair took the opening set 4-1 in 15 minutes before losing 2-4 in the second and 2-10 in the match tie-break.

Djokovic then cut a practice session short after just 40 minutes.

Sinner out, Djokovic among the top seeds

The tournament had already lost the world No. 1. Jannik Sinner withdrew on 21 August with a right knee injury that has kept him off the tour since he beat Alexander Zverev to defend his Wimbledon title in July.

“I still need more time to recover from my right knee issue,” Sinner wrote on social media.

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It is the first Grand Slam Sinner has missed since his major debut at the 2019 US Open, and it removes the defending finalist from the top of the draw.

Djokovic opens his singles campaign against American Learner Tien when the main draw begins on Sunday 30 August.

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