Coco Gauff overcame illness to beat Sorana Cirstea 4-6, 7-5, 6-1 and reach the Madrid Open last 16.
The American vomited courtside and needed a medical timeout but still battled through in over two hours.
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She joins a growing list of players hit by a stomach virus in the Spanish capital, with Iga Swiatek, Marin Cilic and Liudmila Samsonova all sidelined.
Gauff, last year’s runner-up, now faces Linda Noskova as she defends heavy clay‑season points.
