Tomoyuki Sugano became the latest Orioles pitcher tonight to face the same team in back-to-back starts. Dean Kremer did it against the Astros and went from tossing seven scoreless innings in Houston to allowing three home runs in the first inning at Camden Yards.

Kremer is a member of the two-timers club, also making consecutive appearances against the Twins in May and producing worse results in the rematch.

"That’s one of the scheduling challenges everyone has to face," he said over the weekend.

Sugano experienced it and was burned twice by the long ball in the Orioles’ 4-3 loss to the Red Sox before an announced crowd of 15,740 at Camden Yards.

The Orioles couldn’t convert leadoff doubles in the seventh and eighth innings and fell to 60-71.

Sugano worked six innings and threw 87 pitches. He allowed four runs and six hits, with two walks and six strikeouts, and his ERA increased from 3.97 to 4.06. Grant Wolfram replaced him in the seventh and retired all six batters.

Tonight marked the most earned runs allowed by Sugano since July 2 in Texas. He faced the Red Sox in his last start at Fenway Park and surrendered only an unearned run in five innings.

“Obviously, they looked over my data from my last start," Sugano said via interpreter Yuto Sakurai, "so I was kind of seeing what their approach was and going about my business.”

Roman Anthony led off the game with a 410-foot home run off Sugano, chasing a high strike and barreling a fastball, and Jarren Duran went 407 feet with his three-run shot in the fifth that gave the Red Sox a 4-3 lead. Sugano’s splitter stayed near the middle of the strike zone after singles by Connor Wong and Anthony to begin the inning.

Sugano hadn’t allowed a home run in his last four starts and 106 batters faced.

“I think they had an approach for pitches down, especially for the left-handed hitters, particularly the splitter," he said. "I think they were kind of like focusing on that pitch.”

“Roman Anthony leading off the game, he jumped him right there," said interim manager Tony Mansolino. "I think it was two strikes. Just a good swing. That kid’s a pretty good player. Just a talented player that got him right there. I thought Tomo threw the ball really good. He made one mistake, and I don’t even know if it was a mistake. It was the split. It wasn’t necessarily up, it wasn’t necessarily down. Kind of ran into the loop a little bit right there for Duran and put a good swing on it.

"Cowser, on a normal night where you can see or a different time of night, he might catch that ball. Just really hard for him to see kind of going up. He was a little bit early. But you’ve got to give those two hitters credit. They jumped Tomo, but I thought Tomo threw the ball great.”

Rookie Samuel Basallo caught Sugano for the first time.

“We talked a little bit yesterday and I think he did his best today," Sugano said. "And we have a few more starts that we’re probably going to work together, so I’m quite excited about it.”

Colton Cowser spent one day atop the Orioles’ order while Jackson Holliday was given a reset on the bench. Interim manager Tony Mansolino lowered him to sixth again tonight in the latest iteration of the lineup.

The bat seems to play anywhere lately.

Cowser hit his third homer in the last four games, clearing the fence in center field against reliever Richard Fitts in the second inning for a 1-1 tie. Brennan Bernardino, used as an opener, struck out two batters in the first and worked around Jeremiah Jackson’s one-out infield hit and shortstop Trevor Story’s throwing error on the play.

The Orioles loaded the bases with two outs in the third on walks to Gunnar Henderson and Coby Mayo sandwiched around a sinker that hit Ryan Mountcastle. Cowser grounded a 1-2 changeup into center field for a 3-1 lead.

Cowser has nine hits and eight RBIs in the last six games. His last three-hit game was July 18 in Tampa.

“I think he’s grown up a lot right now in a lot of ways,” Mansolino said. “I think what happens to these guys when they struggle, like really struggle for the first time, they grow up, and when they grow up there’s accountability. And when you have accountability in this thing you kind of take off.

“Just talking to Colton every day, he’s working his butt off. He hasn’t stopped. He stayed optimistic. He’s fun. The whole thing. Couple 0-0 breaking balls lately he’s hit over the fence. I don’t think we’ve ever really seen that out of him, so you can see adjustments being made and he’s getting better. So proud of the kid. He’s hung in there through a lot of injuries and time off the field this year and he’s struggled and he’s been disappointed in himself, but feels like he’s coming out on the other end at the moment.”

Fitts retired seven batters in a row, threw one pitch to Coby Mayo leading off the sixth and walked off the field with an athletic trainer. Fitts looked down at his arm after unleashing a fastball, and the Red Sox said he had right biceps tightness.

Steven Matz entered the game, struck out Mayo and allowed an opposite-field single to Cowser, who began the night batting .164 (10-for-61) against left-handers. Samuel Basallo grounded into a double play.

(Basallo has impressive tools, but running isn’t counted among them.)

Dylan Carlson led off the seventh with a double and was thrown out at third base on Luis Vázquez’s attempted sacrifice bunt. The safe call was overturned.

Henderson doubled off Garrett Whitlock to begin the eighth and the next three batters struck out, including Cowser to end the inning.

"Wasn’t disappointed in the at-bats by any means," Mansolino said. "I thought the at-bats were solid. Just wasn’t able to get those two runners at second over to third base, and can’t do that. It’s hard to win in this league.”

Boston threatened to score an insurance run in the ninth against Corbin Martin, who committed a two-base throwing error on a pickoff attempt. Pinch-runner Jhostynxon Garcia reached third base with one out and was stranded on back-to-back strikeouts.