KEY BISCAYNE, Fla. – Facing match point and feeling lousy, Andy Roddick bent over behind the baseline with his hands on his thighs, looking like someone desperately needing to take a seat in the shade.
That's where he was headed one point later. An ailing Roddick lost his opening match Saturday at the Sony Ericsson Open to Pablo Cuevas of Uruguay, 6-4, 7-6 (4).
Two-time champion Roddick requested three visits from a trainer in the second set and said he had trouble breathing because of chest congestion. He has struggled to shake a bronchial infection he contracted last month and plans to see a doctor when he returns home to Austin, Texas.
Roddick began limping at the end of the match and said he also had an injury, but he declined to elaborate.
"I have to get some stuff looked at," a wheezy Roddick said.
Much more robust were No. 1-seeded Rafael Nadal and No. 3 Roger Federer, who easily advanced to the third round. In women's third-round play, No. 1 Caroline Wozniacki beat No. 29 Daniela Hantuchova 6-1, 7-6 (7).
Roddick played with a mild case of mononucleosis last summer, and he's wondering about the extent of his current malady.
"It's deep in the chest," he said. "It's not even so much nasally or throat or anything like that. It's just when I laugh, I start sounding like a car trying to start."
There was nothing to laugh about against Cuevas, a 25-year-old journeyman who beat a top-10 player for the first time. The defeat is expected to drop Roddick from eighth to about 15th in the next rankings, the lowest he has been since 2002.
Roddick said the way he felt, he wasn't surprised to lose.
"I didn't feel very optimistic throughout the day," said Roddick, who won the Key Biscayne title in 2004 and 2010.
Nadal, seeking his first Key Biscayne title, held every service game and beat Kei Nishikori 6-4, 6-4. LeBron James and Dwyane Wade took part in the pre-match coin toss, then watched most of the first set from the front row behind the baseline.
Federer defeated Radek Stepanek 6-3, 6-3 for his 762nd victory, tying him with Pete Sampras for seventh place in the Open era.
"It's nice tying Pete, but he could have played for many more years," Federer said. "He could still win some matches on tour now if he wanted to."
Federer, who won Key Biscayne in 2005 and 2006, faced only one break point against Stepanek and has won 18 consecutive sets from the Czech.
"I was able to play solid and keep him moving and serve at a high first-serve percentage," Federer said. "All in all, I'm really pleased."
He improved to 19-3 this year, with all three losses to Novak Djokovic. They could meet in the final next Sunday.
Six other seeded men lost: No. 10 Jurgen Melzer, No. 18 Marin Cilic, No. 20 Albert Montanes, No. 22 Marcos Baghdatis, No. 26 Juan Ignacio Chela, and No. 28 Ernests Gulbis. Melzer was beaten by friend and doubles partner Philipp Petzschner 6-3, 6-4.
No. 13-seeded Mikhail Youzhny drubbed Yen-hsun Lu 6-1, 6-0. No. 15 Jo-Wilfried Tsonga beat Teymuraz Gabashvili 6-3, 6-7 (3), 6-3.
In women's play, No. 16 Maria Sharapova advanced to a fourth-round matchup against No. 4 Samantha Stosur by beating Sabine Lisicki 6-2, 6-0. No. 11 Svetlana Kuznetsova, the 2006 champion, lost to Peng Shuai 6-3, 6-1.
Roddick's 16-4 this year despite his health issues. He won the Memphis final a month ago playing with what he thought was a bad cold he caught from his wife. He withdrew two days later from the Delray Beach tournament, then won two matches to help the U.S. Davis Cup team beat Chile in Santiago in early March.
Roddick said he felt fine at Indian Wells, where he reached the fourth round last week. When he arrived in Key Biscayne, his health worsened again.
"I have been coughing, but it hasn't been affecting my breathing or energy levels until the last couple days," he said.
He struggled from the start against Cuevas, lost serve to fall behind 4-3 in the first set and trailed the rest of the way. Cuevas never dropped his serve and hit 15 aces, with Roddick often slow to react on his returns.
Big first serves kept Roddick in the match — he reached 142 mph, then hit three aces in the tiebreaker to keep it close. But he was erratic with his backhand and volleys, and went 0 for 4 on break points.
"You don't like going out there with less than what you got, and I feel like I have been doing that a lot," Roddick said. "It's just frustrating."
The defending men's champion lost his opening match for the second year in a row. Andy Murray was beaten in 2010 by Mardy Fish.