Los Angeles Angels first baseman Casey Kotchman is tagged out at the plate by Red Sox catcher Kevin Cash in the second inning.

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The Providence Journal / Bob Breidenbach

BOSTON –– Terry Francona often preaches patience. He speaks about how it is needed to get through the long baseball season.

Rarely has patience been more important for his team than it is right now, although not for the usual reasons.

Francona’s Red Sox saw their winning streak end at six games when they were beaten, 6-4, by Los Angeles last night, but that is the least of their worries right now. The crazy string of injuries and health issues brought on by the flu bug are the opponents the Sox have to worry about most.

The health situation, already serious, became even wilder last night, when the Sox had to pull their scheduled starting pitcher for the second straight game. This time, it was Daisuke Matsuzaka who was felled by the flu. The Sox, who had brought up David Pauley Tuesday to replace the injured Josh Beckett, had no one available to start.

About 4:30 p.m., Jon Lester was working with pitching coach John Farrell when Francona came along and told the two of them that Matsuzaka was out.

“I said, ‘I’ll pitch if you need someone,’ ” Lester related. “He kind of laughed and threw it to the side. Fifteen minutes later, he came back.”

This time Francona wanted to know whether Lester, who had been scheduled to start today, really felt he could do it. Lester said yes, and suddenly he became the starting pitcher.

“It was different, no pain or soreness or anything like that,” he said. “`It didn’t feel like the normal five days. That’s not an excuse. . . It was just different.”

Lester gave up nine hits and four runs in four innings, but did not get the loss. That went to Craig Hansen.

Oh yes, Hansen was brought up earlier in the day to replace Pauley and help the bullpen. Hansen actually pitched pretty well, but got too much of the plate on a pitch he was trying to get inside to Casey Kotchman in the sixth. Kotchman hit it into the Boston bullpen for what turned out to be the winning run.

The zaniness is not over. With no one available today because Lester moved up, the Sox will promote Justin Masterson from Double-A Portland to make the start this afternoon.

“We’re just going to have to work through this, take the issues every day and do the best we can,” Francona said, this time with everyone understanding his desire for patience.

The Sox players seemed as unsure as anyone else about what is going on.

“We were out there in batting practice and usually we see Daisuke come out and start warming up,” said Jed Lowrie. “He never came out. Then we got back in and saw Lester’s name on the lineup card.”

A crowd of 38,172, the largest in the modern era, took in the game. It was the 400th straight sellout. The only team that has had more is Cleveland with 455 in the 1990s after opening its new field.

Last night’s problems were merely the latest in long line of issues for the Sox.

Mike Lowell and Alex Cora remain on the disabled list. Kevin Youkilis, who did not play last night (back pain), Jason Varitek, Coco Crisp, J.D. Drew, Manny Delcarmen, Clay Buchholz and Mike Timlin all have had injury or flu problems already this season. All that, of course, does not include Curt Schilling, who is on the 60-day disabled list with shoulder problems.

It’s as if there is a cloud hanging over the team. There were more scares last night.

Kevin Cash made an awkward slide into second base on a double to the base of the bullpen. He did not slide properly and went in on his stomach, enough to be shaken up. Dustin Pedroia hurt his hand when he slid head first into first base to avoid a tag on an infield hit. He was attended to briefly. Julio Lugo fouled a ball off his foot in the sixth and he, too, had to be examined. The good news for the Sox is that in all three cases, the players stayed in the game.

Even with all the problems, the Sox still had a great chance to win it. They put two runners on with one out in the eighth on singles by Sean Casey and Lugo. The shorthanded situation hurt. Casey is one of the slowest players on the team. He was at second representing the tying run, but there was no one to pinch-run or replace him defensively if he left.

The next two hitters were Lowrie, a rookie, and the backup catcher, Cash, who also was the only available catcher. The stage was set. Three times in the last six games, the Sox have won with eighth-inning rallies. In five of the six, they have scored at least one run in the eighth.

This time, the magic wore off. Lowrie grounded into an inning-ending double play. Frankie Rodriguez then came on in the ninth and retired the side in order to end Boston’s six-game winning streak.

The players have to wonder what could be next. Tim Wakefield, who is scheduled to go in Tampa Bay when the Sox hit the road, came into the clubhouse after last night’s game and was hacking and coughing as he picked up personal belongings and headed home.

It does not look as if everything will get back to normal any time soon.

Next Game

Today

vs. Angels

1:35

pkenyon@projo.com