Can you have bacterial meningitis without having a fever?

Very,Very Rarely: Almost always, bacterial meningitis is accompanied by fever and the patient has serious symptoms such as severe headaches, stiff neck, vomiting, occasional loss of of consciousness.But I have seen it without fever in children.

Highly unlikely: The symptoms of meningitis are fever, stiff neck, head ache, altered mental status and in some cases seizures. Viral meningitis is usually milder than bacterial meningitis . It would be very unusual to have bacterial meningitis without a fever. This would only occur in the very elderly or the severely immunosuppressed.

Yes: Uncommon, but not unheard of. Elderly patients sometimes present with change in mental status only.

Yes ...but...: I've seen it in an 8 yo who presented in coma after spending the night on a sofa. He had poor blood pressure, no blood cell response, no fever and a spinal tap teeming with meningococcal germs. His system had no immune response to the germ & he died within hours. I consider it an outlier, as 100% of my other cases had fever.

Possibly: I can remember one 8 yo kid that arrived in a coma with low body temperature, low blood pressure & died within hours of Meningococcal meningitis/sepsis. He also showed no increased in white count or other sign of an immune response. That was the exception to the usual presentation with fever, irritability etc for hundreds of cases i treated.Beware the always/never idea for anything.