Syrian rebels attacked a checkpoint in a pro-government suburb of Damascus, setting off a suicide vehicle bomb that killed 16 soldiers, according to activists.
It came as the UN-Arab League envoy began a regional push for peace talks.
Meanwhile, the US said children were starving to death in besieged areas of the capital and demanded that the regime allow aid convoys in.
The Syrian Observatory for Human Rights said a suicide bomber from the al Qaeda-linked Al Nusra Front detonated an explosives-packed car at the checkpoint between Jaramana and the rebel-held area of Mleha.
State media blamed the blast on "terrorists", the regime term for rebels.
Heavy fighting followed, with rebel mortar fire hitting Jaramana, said the Britain-based Observatory, which relies on activists and medics on the ground for its information.
One resident said the intensity of fighting was "unprecedented" since the conflict erupted in March 2011.
The wreckage of a car bomb explosion in Jaramana in July The war, which began after President Bashar al Assad launched a bloody crackdown on democracy protests inspired by the Arab Spring uprisings, is believed to have killed more than 115,000 people.
Washington condemned the regime's relentless siege of rebel-held Eastern Ghouta and Moadamiyet al Sham on the capital's outskirts.
US State Department spokeswoman Jen Psaki said there were "unprecedented reports of children dying of malnutrition-related causes in areas that are only a few miles from Bashar al Assad's palace in Damascus".
She added: "The regime's deliberate prevention of the delivery of lifesaving humanitarian supplies to thousands of civilians is unconscionable.
"We call on the Syrian regime to immediately approve relief convoys into these areas."
The call came as UN-Arab League envoy Lakhdar Brahimi was to arrive in Cairo at the start of a regional tour aimed at paving the way for peace talks.
World powers hope to convene a peace conference in Geneva next month but prospects for it remain unclear, with Syria's opposition divided and due to vote next week on whether to take part.
Mr Assad's government says his departure from office cannot be on the table, while the opposition insists he cannot remain in power.
Separately, US Secretary of State John Kerry will head to Europe next week for talks on Syria.
He and other envoys from the "Friends of Syria" group will meet the Syrian opposition in Britain on Tuesday to review progress towards convening the conference.
The National Coalition, Syria's main opposition bloc, said it would hold internal discussions next week to decide whether to do so.
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