Fish, who reached No. 7 in the world in 2011, left with a groin injury at 3-3 against Boston's Amir Weintraub in men's singles.
The match was tied 12-12 at that point, and host Sacramento went on to lose 23-19. It was the Capitals' first loss of the season after three wins. They play their first five matches at home.
Fish, 31, returned to competition on Sunday in Sacramento's season opener after battling an irregular heartbeat for 17 months. He has played in only two tournaments, in March and April, since the U.S. Open last September.
Ryan Sweeting, who has plunged from a career-high No. 64 in 2011 to No. 525, replaced Fish on Friday and lost to Weintraub 5-3.
Megan Moulton-Levy and Taylor Townsend, 17, then won 5-4 in women's doubles to pull Sacramento within 18-17 entering the last set. But Knowles and the 6-foot-5 (1.96-meter) Sweeting lost to Eric Butorac, a former Capital, and Weintraub 5-2.
Knowles, 41, and Sweeting, who turns 26 on Sunday, were both born in Nassau, Bahamas. Sweeting, though, moved to Fort Lauderdale, Fla., at 12 and became an American citizen in 2006. He won the U.S. Open junior boys singles title in 2005.
BOSTON 23, CAPITALS 19
In Citrus Heights, Calif.
Mixed doubles -- Mark Knowles and Megan Moulton-Levy (Capitals) def. Eric Butorac and Katalin Marosi, 5-4.Women's singles -- Jill Craybas (Boston) def. Taylor Townsend, 5-4.
Men's singles -- Amir Weintraub (Boston) def. Ryan Sweeting, 5-3. Sweeting substituted for Mardy Fish at 3-3.
Women's doubles -- Moulton-Levy and Townsend (Capitals) def. Craybas and Marosi, 5-4.
Men's doubles -- Butorac and Weintraub (Boston) def. Knowles and Sweeting, 5-2.
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