Does pneumonia always have a fever with it?

Usually: Pneumonia is generally described as a febrile illness with a cough and a chest x-ray finding consistent with infection in one or more lobes of the lung. Immune compromised patients or very elderly patients may not have a fever.... But even they usually do.

No: There are many kinds of pneumonia or infection in the substance of the lung. Some have high fevers, many have lower fever and some have none. They vary by the germ causing the pneumonia and how much of the lung is infected. Fever may also vary by how strongly the body fights the infection. Usually, as fever goes away, the infection is getting better.