Despite being diagnosed of appendicitis Sunday, World No. 2 Rafael Nadal went onto the court but lost in an all-Spanish Encounter while John Isner won his all-American battle against Steve Johnson at the Shanghai Rolex Masters in China on Wednesday evening.

Feliciano Lopez quickly went to work as he broke the eight-time French Open champion once in the first set to take the early lead.

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The second seeded Nadal jumped into an early lead 4-1 in the second set but Lopez bounced back to break the Spaniard twice to level the score at 5-all. Both then held to their serves to send the set into overtime.

Both players were giving it their all at the tie-break as neither player would give up on their serves but Lopez had an opportunity for a match point at the 14^th game and took it to hand over Nadal's second loss after coming back from injury 6-3 7(8)-6(6).

The 33-year-old Lopez will then play 13^th seeded Isner in the next round.

The loss might not be all that bad for this would be a great opportunity for Nadal to consult with his doctors in Mallorca if he would get an operation to remove his appendix, however, he might pull out his participation at the year-ending WTA Tour Finals in London.

Isner, 29, won a thrilling two set matchup against fellow American and former doubles partner Johnson with both sets ending up in a tie-break 7(8)-6(6) 7(9)-6(7).

Both players just wouldn't let up on their serves as each player delivered on their serves but Isner wound up on top in an epic all-American battle.

Coincidentally, Isner and Johnson won their opening matches in three sets, winning the first and the deciding set against Pablo Andujar and Andrey Gobulev respectively.

Isner stands 6-foot-10 and is second in the ATP in service aces this year next to Ivo Karlovic, who stands 6-foot-11. He has the best record for service games won at 93 percent in 46 matches and an incredible 75 percent of break points saved.

Tagsrafael nadal, John Isner