Novak Djokovic crashes out of US Open in five-set defeat to Mariano Navone

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Novak Djokovic crashed out in the first round of the US Open after a five-set, near five-hour ordeal during which he was repeatedly sick on court.

The 39-year-old looked physically spent throughout the match and was regularly doubled over in pain, but still took Argentina’s Mariano Navone the distance.

Djokovic swallowed pills and used an inhaler after vomiting at least three times, but despite being in obvious discomfort, he refused to throw in the towel.

The 39-year-old was frequently doubled over in pain (Frank Franklin II/AP) (AP)

However, the 24-time grand slam champion could not prevent a 7-6 (5) 5-7 4-6 6-2 6-1 defeat and first exit in the opening round of a major since Paul Goldstein beat him at the Australian Open in 2006.

The last time the Serbian great had been seen on a tennis court, in Cincinnati two weeks ago, he was collapsing to his knees and being sick into a towel.

After that defeat by Thiago Tirante, Djokovic revealed he had a “health issue” which he has been dealing with “for many years”, and which affects him in heat and humidity.

It was certainly warm in New York but by no means Cincinnati levels, yet Djokovic’s cheeks were already red and his hair drenched in sweat midway through the first set, which he had led 3-0 but lost in a tie-break.

Novak Djokovic waves goodbye after his first-round exit (Frank Franklin II/AP) (AP)

Having already successfully lobbied to have the roof closed, and with it the air conditioning switched on, Djokovic hit back late in the second set – after throwing up by the courtside towel box – with the crucial break for 6-5.

He was sick again midway through the third but still took his one chance to break serve, and vomited again at the start of the fourth before breaking once more for 2-1.

However, by now Djokovic appeared to be cramping up and he could barely move as Navone struck back, winning just one more game in a dramatic defeat over four hours and 36 gruelling minutes.

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