BEIRUT, Lebanon — 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 bombings.

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 of people having fled as a Palestinian faction that supports the Assad government skirmished with government opponents in three southern neighborhoods.

“It’s a real war,” said an activist reached in southern Damascus 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,” she said.