Boston starting pitcher Chris Sale delivers a pitch against the Orioles on Monday in Baltimore. Sale went five innings, allowing five runs on nine hits with one walk and no strikeouts. Julio Cortez/Associated Press

BALTIMORE — Yennier Cano filled in for closer Félix Bautista in the ninth inning and not much changed.

It ended with another Baltimore victory.

Cano struck out two in the ninth and earned his first career save, and the Orioles held on for their seventh straight victory, 5-4 over the Boston Red Sox on Monday night. After Danny Coulombe allowed a leadoff walk, Cano came on and balked the runner to second before striking out Kiké Hernández and Triston Casas and retiring Jarren Duran on a lineout.

“It was a bit nerve wracking. I’ve never come into a major league game in the ninth inning trying to close it out,” Cano said through a translator. “At the end of the day it all remains the same – trying to go out there and do the job.”

Bautista had the night off, which left the game in the hands of Cano, who has not allowed a baserunner in six appearances since coming up from the minors April 14.

“He throws mid-90s with a disgusting changeup,” Orioles starter Dean Kremer said. “He’s basically Félix from shoulder height.”

It wasn’t clear if that was a reference to Cano’s arm slot when he releases the ball or the difference in height between the 6-foot-4 right-hander and the 6-foot-8 Bautista. The bottom line is they’ve both been effective.

Ramón Urías hit a two-run double in the fourth, and the Orioles rallied from a four-run deficit against Boston starter Chris Sale. Masataka Yoshida had three hits for Boston.

Sale (1-2) allowed nine hits – one by each member of the Baltimore batting order – in five innings, failing to hold onto a 4-0 lead after Triston Casas and Rafael Devers homered for Boston. Kremer (2-0) wasn’t great either, but he made it into the sixth inning after some early struggles and gave his team a chance to come back.

Sale was coming off an 11-strikeout performance against Minnesota in his previous outing, but he didn’t have any against the Orioles. In fact, Baltimore made contact on 40 of its 42 swings against him. The left-hander’s ERA increased to 8.22.

The Baltimore hitters didn’t have a single strikeout in the entire game.

“I’m putting in the work, just not showing up,” Sale said. “You either get it done or you don’t, and unfortunately for the most part this year I haven’t got it done.”

The damage against him could’ve been worse. The Orioles grounded into three double plays and had a runner thrown out stealing during Sale’s five innings. Baltimore hit into another double play in the eighth.

After Kremer exited, the Baltimore bullpen pitched 3 1/3 hitless innings.

Casas opened the scoring with a solo homer in the second, and after an RBI single by Alex Verdugo the following inning, Devers hit a two-run shot to make it 4-0.

The Orioles began their rally in the bottom of the third when Adam Frazier hit an RBI single. Urías’ double in the fourth made it 4-3, and he came home on a tying single by James McCann.

Austin Hays hit an RBI single in the fifth to give the Orioles the lead, then threw Justin Turner out at third from left field an inning later to help Baltimore stay ahead.

Red Sox hitting coach Peter Fatse was ejected in the sixth on a night Boston wasn’t pleased with the strike zone.

“We were displeased from the first inning,” Manager Alex Cora said. “I’ll probably get in trouble if I keep talking, but I wasn’t too pleased with it.”

NOTES: The Red Sox recalled LHP Brennan Bernardino from Triple-A Worcester and optioned RHP Brayan Bello to Worcester before the game. … The Orioles promoted INF Jackson Holliday to Aberdeen, the team’s advanced Class A affiliate. Holliday was the No. 1 pick in last year’s draft. … Red Sox shortstop Yu Chang left in the seventh with a left wrist issue. Christian Arroyo went up with two strikes to finish that at-bat, but the eventual strikeout was charged to Chang.