Cards' Carlos Martinez leaves in fourth inning because of fatigue

ST. LOUIS -- Cardinals right-hander Carlos Martinez left in the fourth inning of Friday night's 4-2 loss to the Pittsburgh Pirates because of fatigue. He will be re-examined Saturday, the team announced.

After getting Jung Ho Kang to pop an infield fly with no outs and the bases loaded in the fourth inning, Martinez was met by his infielders on the mound. Catcher Yadier Molina motioned to the bench for manager Mike Matheny and a trainer to tend to Martinez. He left the game with the Cardinals trailing 1-0.

"We all saw that one particular pitch, and he had a different body language," Matheny said. "I think we could all see that early on, but he was still making pretty good pitches."

Martinez has been plagued by his health in each of his past two starts. He dealt with flu-like symptoms in a 6-1 loss to the Washington Nationals on Sunday but did manage to throw 87 pitches in 6⅔ innings.

On Friday, he lasted 3⅓ innings and threw only 52 pitches.

Long reliever Tyler Lyons replaced Martinez and struck out the final two batters to leave the bases loaded.

Speaking with reporters after the game, Martinez paused to cough multiple times and appeared exhausted.

"In the first inning, I felt good," he said through an interpreter. "In the second inning, I started feeling a little tired."

Martinez breezed through the first inning in four minutes of work, retiring the first three batters on 11 pitches. Nine of the pitches were fastballs, topping out at 98 mph. Against the next 12 batters, he allowed three hits, three walks and one run.

By the end, he said he felt dehydrated.

According to Matheny, Martinez's illness is similar to what plagued reliever Kevin Siegrist and second baseman Kolten Wong earlier this season.

"The whole thing has been going through the clubhouse," Matheny said. "We seem to be on the backside of it."

Asked if he thought about telling Matheny about his condition before the game, Martinez said he couldn't "because we're facing a good team." Matheny reiterated that he wasn't aware of any lingering effects on Martinez's health.

Martinez, who said he has lost 5 to 10 pounds because of his illness, said he plans to take a couple days off to rest, but has no plans to miss his next start.

Martinez is 4-2 with a 2.61 ERA in six starts this season.