According to his manager, the South African woke up on Thursday morning suffering from an upset stomach and vomiting before returning to his American home in Orlando to recover.

"Trevor is certainly disappointed with the timing of this illness as the Players Championship is a tournament he and all the players look forward to each year," said his manager Jon Wagner.

"His main focus now, though, is to use this time that he had previously scheduled off to get well and to prepare himself for the next event."

Immelman, who became the first South African to win the Masters since Gary Player in 1978, has missed the cut in his last two PGA Tour starts.

Argentina's defending US Open champion Angel Cabrera ended two under, while South African Ernie Els also finished level par for his first round.