Serena Williams retired from her Indian Wells match against Garbine Muguruza citing “extreme dizziness and extreme fatigue”.
Muguruza was winning 6-3 1-0 when Williams was forced to withdraw from the third round meeting.
Williams had gone 3-0 ahead but after losing six consecutive games, she called for the trainer. She emerged for the second set but it was short lived.
"Before the match, I did not feel great and then it just got worse with every second - extreme dizziness and extreme fatigue," 23-time Grand Slam champion Williams said.
"By the score it might have looked like I started well, but I was not feeling at all well physically. I will focus on getting better and start preparing for Miami."
A sharp Philipp Kohlschreiber broke Nick Kyrgios twice en route to a shock 6-4 6-4 win that took just over an hour.
Auger-Aliassime stuns Tsitsipas
Third seed Alexander Zverev had a stress-free opening match of the tournament, winning 6-3 2-0 over Martin Klizan, who was forced to retire with a right ankle injury in the second set.
Venus Williams fought back to down third seed Petra Kvitova 4-6 7-5 6-4, while Naomi Osaka got her title defence off to a flying start with a straight sets win over Kristina Mladenovic.
World No 1 Osaka beat Mladenovic 6-3 6-4, the win under the stadium court lights sweet revenge for the reigning US and Australian Open champion after she lost to the same opponent in the Dubai Duty Free Tennis Championships first round last month.
"I've never been a defending champion before so I was pretty nervous and I'm glad I got the win," the Japanese 21-year-old said.
Konta advances; Evans out in California
Former world No 1 Angelique Kerber was nearly perfect en route to a 6-0 6-2 dismantling of Yulia Putintseva, winning 93 per cent of her first service points under sunny skies.
— MEN's Draw—
In the men's draw, Roger Federer and Rafael Nadal cruised into the round of 32.
Nadal thrashed Jared Donaldson 6-1 6-1 and Federer beat Peter Gojowczyk 6-1 7-5.
World No 1 Novak Djokovic picked up steam during his second-round match against American Bjorn Fratangelo as he goes in search of his 74th ATP title in Indian Wells.
Djokovic sprinted over to the stands to shake hands with his idol, 14-times Grand Slam champion Pete Sampras, immediately after the 7-6 (7-5) 6-2 win.
"I was a bit nervous, I don't get to see Pete that often," the 31-year-old Serb told reporters.
"It's a thrill to see someone that I looked up to when I was a kid."
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