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BEIRUT — Some of the worst violence in months racked Syria on Monday with residents of southern Damascus fleeing heavy shelling, several smaller towns shattered by air attacks, and at least two car bombs.

The Local Coordinating Committees, a collection of activist organizations across Syria, said the daily toll reached at least 159, including 72 killed in Idlib, and 47 in Damascus and its suburbs.

People in Damascus, the capital, said the fighting was the fiercest they could remember since July, with thousands fleeing as a Palestinian faction that supports the Assad government skirmished with government opponents in three southern neighborhoods.

“It’s a real war,” an activist reached in southern Damascus said via Skype, who used only one name, Eman, for her safety. “Explosions, bombing and gunfire, and of course the helicopters, which have become part of the sky in Damascus now, like birds.”

The fighting, escalating over three days, ignited the quarters of Yarmouk and Tadamon, both heavily Palestinian, as well as Hajjar al-Aswad, a center of resistance to the government.

Syria took in large numbers of Palestinians who fled their homes at the founding of Israel, and they and their descendants number about 450,000 now. Many have sided with those leading the uprising, but the Popular Front for the Liberation of Palestine-General Command, a faction with a prominent role in the neighborhoods, still supports the government. Much of the fighting involved Popular Front units, backed by government artillery. Rounds fired from the military airfield in Mezze slammed into the area, activists said.

Yarmouk, founded as a Palestinian refugee camp in 1957, gradually became a residential district barely distinguishable from the rest of greater Damascus. A Facebook page focused on camp news published a statement from the Popular Front group saying it had thwarted an infiltration by government opponents.

“When the terrorists failed to enter, they fired mortars killing a large number of martyrs and wounding a lot of people,” the statement said.

Civilians have been fleeing in droves. Small artillery hit a minibus carrying people trying to escape from Yarmouk, killing five of them. Each side blamed the other for that strike. Displaced families have started camping in back gardens or schoolyards, Eman said.

A car bomb exploded in Mezze 86, a Damascus neighborhood on the slopes below the official palace that houses the offices of President Bashar Assad. The area is heavily populated by families linked to the security forces, which Assad’s Alawite minority dominates. Pictures posted on Facebook showed a large black column of smoke rising from the area.

The Free Syrian Army claimed responsibility for that attack, saying in a statement that it targeted military officers and members of the armed militias who fight for the government.