Elena Rybakina withdrew from the Eastbourne International citing a viral illness on Monday, a week before she's due to defend her Wimbledon title.
Eastbourne, where Rybakina was seeded No. 1, made the announcement before her scheduled first-round match.
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Rybakina withdrew last month from the French Open, also citing a viral illness, before her third-round match. Since then, the Kazakh appeared at the Berlin Open last week and lost in the second round.
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Former No. 1 Karolina Pliskova, a two-time Eastbourne champion, moved past Elise Mertens when the Belgian retired with a left hip injury while trailing 6-7 (3), 6-3, 3-0.
Pliskova, the Eastbourne winner in 2017 and 2019, will play Daria Kasatkina next.
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On the men's side, sixth-seeded Tomas Martin Etcheverry of Argentina lost his opener to J.J. Wolf of the United States 6-2, 6-4. Wolf earned his first tour win on grass.