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South Africa paceman Dale Steyn will not bowl again in the first Test against England due to a shoulder injury.
Steyn left the pitch mid-over twice on day three due to a spasm in his right shoulder, though scans showed no sign of a muscle tear.
He underwent a morning fitness test at Kingsmead in an attempt to help the Proteas claw their way back into a game that was rapidly slipping away, but again felt discomfort and did not take to the field.
With South Africa facing a stern challenge to save the series opener, Steyn is due to bat if required in the fourth innings.
But with just two days between the fifth day in Durban and the start of the Cape Town Test on January 2, Steyn is also a major doubt for that game.
South Africa team manager Dr Mohammed Moosajee, who accompanied Steyn to hospital on Monday, told Test Match Special that the 32-year-old was "touch and go" for the second game.
Kagiso Rabada is already in the Proteas squad as the spare seamer, but an SOS may now be issued to Marchant De Lange, who is next in line.
Steyn was an injury doubt for the first Test having spent seven weeks on the sidelines with a groin strain and, although he passed a rigorous fitness test before Christmas, South Africa believe the lay-off may have been a contributing factor to his current problems.