Can menigitis be present without fever?

Answer 1

Yes- in immune compromised individuals such as neonates, the elderly, or HIV/cancer chemotherapy patients one may see either little or no rise in body temperature, or actually a decrease in body temperature with overwhelming infection (usually sepsis but could be with meningitis, too.)

The sina quo non of meningitis are "minengial irritation signs" -- headache, stiff neck, photophobia, +/- decreased level of consciousness (a late, ominous sign).

That said - I have only seen one or two cases of suspected meningitis w/o fever.